What could cause a rapid heart rate?

Question

Hello doctor,

Almost a year ago, I had a weird heart episode and I thought I would come on here to try to get an answer as to what was happening physiologically. I was 16 years old when this happened and I am a female. There was no history of anxiety or panic attacks. There is a history of unexplained rapid HR, resting HR ranged from 97 to 110. Following this event, I got put on Metaprolol which has lowered my resting HR to 85 and has helped immeasurably. I was sitting down, relaxed, listening to music at school, when I got intense chest pain, I did not feel nervous due to having reflux, I also got a wave of nausea, but thought nothing of it, this continued for a minute or two and suddenly the chest pain severely intensified. This prompted me to get up and make my way down to the nurse. The entire way down, I was weaving in and out of consciousness, the chest pain persisted, my throat felt like it was closed and I felt like I was going to vomit, and above all, it was like I had the foresight of my death. After all the symptoms continued for that minute, I felt all the symptoms got resolved. At this point, the nurse finally took my HR and it was 122, which is not high for me. Although I felt fine, I still went home, and only after I left the school, I started crying because of how shaken up I was. I realized I did not feel fear during the episode. Any insight on this would be greatly appreciated.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

It is difficult to diagnose without a full medical checkup, and must rule out paroxysmal supraventricular tachycardia (PSVT) or vasovagal syncope. These conditions can cause rapid heart rates, chest pain, and feelings of impending doom.

Paroxysmal supraventricular tachycardia is a type of abnormal heart rhythm (arrhythmia) where your heart suddenly beats much faster than normal due to electrical disturbances in the heart's upper chambers. These episodes can cause chest pain, nausea, lightheadedness, and a sense of impending doom.

Vasovagal syncope is characterized by:

Sudden drop in heart rate and blood pressure leading to fainting or near-fainting.
Feelings of dizziness.
Lightheadedness.
Nausea and a sense of impending death are characteristic of this response.

It is triggered by stress, pain, or even standing for long periods.

Panic attacks - While anxiety was ruled out by multiple professionals, panic attacks can sometimes mimic the symptoms of a heart issue, including chest pain, rapid heart rate, and a sensation of impending death.

Cardiac arrhythmia can cause lightheadedness, chest pain, and sensation of irregular heartbeats.

You are currently on Metoprolol which is helping control your heart rate. It is also important to monitor the medicine you are taking for ADHD (attention-deficit hyperactivity disorder), as stimulant medications can sometimes increase heart rate or trigger arrhythmias in certain individuals.

Seek immediate medical attention. Must follow up with a cardiologist.

I hope this information will help you.

Thanks.