Q. I am nervous about the increased heart rates. What could be the cause?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 23, 2020

Hi doctor,

I am having neck stiffness and headache as soon as I wake up. I am feeling tired throughout the day. My Apple shows elevated heart rates today. They are 130 mm Hg, 140 mm Hg, 150 mm Hg at different times of the day like 12 PM, 3 PM, 6 PM. Is there something wrong to get worried? I have gone to urgent care two weeks back and they did an EKG and blood test and they mentioned there is nothing to worry about heart attack. I am nervous about the elevated heart rates. My primary care physician did a bunch of blood tests and mentioned to me that there is no problem.

#

Hi,

Welcome to icliniq.com.

First, what you were doing when you had an elevated heart rate? Are you were walking, sleeping or exercising. Did you have any symptoms associated with this high heart beat like chest pain, dizziness or shortness of breath? Do you smoke or have alcohol. Also, upload your baseline ECG. Your headache and neck stiffness is probably muscular due to an abnormal sleeping position or may be cervical, especially if occurs frequently. If it happens frequently then, you should get an X-ray of the cervical spine AP (anteroposterior), lateral view.

If you were doing some activity during those elevated heart rate like some exercises, brisk walking, having any medicines or drug, then it is appropriate and nothing to worry about it. However, if it occurred during rest then, we should rule out cardiac arrhythmias. I guess you must be having ECG tracings of these elevated heart rate or other detailed reports of the high heart rate, if yes, please upload it to diagnose a rhythm. If you do not have, then you will need a 24 hour Holter monitoring. Overall, even if these are due to arrhythmias, these are usually life-threatening.

Thank you doctor,

I was anxious as I was reading some articles about the heart rate. I was taking my lunch where something got stuck in my throat. After this, I had this elevation. I was working with the laptop, during that time again I had elevation in the heart rate. I usually have 99 beats when I check with my PCP. After these incidents, I checked my heart rate. It was 99 beats too. I also have a feeling to have a good sleep even after a good night sleep, when I wake up. I have this feeling for about two weeks. I do not have any chest pain till now.

#

Hi,

Welcome back to icliniq.com.

It is not appropriate. The first elevation may be explained with an episode, but the rest are not. So it should be evaluated. As I mentioned, if you have your ECG tracings then, it will be very helpful. If not then you can arrange it. Apple based Alivecor Kardia monitor provide the ECG tracings and some of the patients used them for rhythm monitoring and you can also do them. You should get one thyroid profile done, if not done recently.

You mentioned your BMI is 47 (attachment removed to protect identity). There is a strong possibility to have obstructive sleep apnea in you, which may lead to snoring, apnea episodes during sleep, interrupted sleep patterns (which may not be recalled), incomplete sleep and daytime somnolence, morning headaches. Also, just try to recall if you have a good quality sleep or any obstructive sleep apnea symptoms. You may ask regarding this to your partner.

So try to have a coffee or caffeine tablet for a week period to stay alert during the day. Focus on weight loss and a healthy lifestyle, regular exercises. Obstructive sleep apnea may predispose to atrial fibrillation which may cause intermittent rapid heart rate. It is one of the possibilities.

Thank you doctor,

I have a back pain in my back. I went to an ENT today. He told me, I may have sleep apnea and ordered for a sleep test and also a CT Scan. Do I want to rule out anything with the heart attack? I went to the urgent care to get my EKG and blood test. I am attaching them here. I also noticed, that I get pins like feeling in my feet. My physician also ordered to do these blood tests like CBC, CMP, stool test, urine test, thyroid, and LDL cholesterol. These ranges are all high.

#

Hi,

Welcome back to icliniq.com.

Your ECG and blood markers for the heart are absolutely normal. So there is no heart attack. Your reports are also fine. Back pain may occur due to multiple reasons and it can be due to muscle spasm which usually settles in two to three days. Also, sometimes there may be a nerve compression or gastroesophageal reflux disease which can also cause back pain.

Pins like feeling is due to nerve or blood vessels compression at the folds of the leg, sometimes nerve compression due to being overweight. So, there is nothing get worried. I guess there is no weakness. If it is frequent, then you may get a nerve conduction studies for neuropathy especially if it is bilateral. Next time when you visit your doctor, just request for a neurological examination like reflex, tone, sensory examination in your lower limbs.

Thank you doctor,

I have a weakness. Before two days, I had a sharp pain in my back in the chest. I have fatigue throughout the day. I feel like sleeping even after a good night sleep. I am getting pain after I played a game of cricket. I also noticed after I run for some time, I hear the sound of my heart pumping. I am very anxious to know what is happening.

#

Hi,

Welcome back to icliniq.com.

Your lipid profile is deranged to some extent, but not very much. So I think you should focus on a healthy lifestyle like low fat, oily, calorie diet. I do not know your lifestyle, but if you have a healthy lifestyle, then it is better to tablet Rosuvastatin 5 mg (Lactose monohydrate) at bedtime which will control the lipid levels. Hearing the sound of heart pumping after exercise is not necessarily an abnormal thing. One may listen to their heartbeat due to fast and vigorous beating, and due to hormones released during exercise. And one can hear and feel the heartbeat, especially whenever we are calm or going to sleep at night.

Sharp pain is musculoskeletal or may be due to a spine problem being overweight which may cause intermittent nerve compression. The cardiac pain would occur on exertion with radiation to left arm and relieves with rest, and again regenerates on the effort. So it is very typical. So historically, it does not appear to be a cardiac pain. I have not mentioned echocardiogram report, so it should be done once as we are suspecting obstructive sleep apnea in you, it should be done to see the heart status and pulmonary hypertension. So you may get it on an elective basis, not an emergency.

Next thing, feeling of weakness and sleepiness throughout the day, is likely a result of obstructive sleep apnea so, after the sleep study, CPAP (continuous positive airway pressure) will help in the resolution of these symptoms. Also, other common cause for this may psychological, so try to motivate yourself.

Thank you doctor,

I was very Anxious over the weekend and went to an Urgent Care and got an EKG done again. The doctor told there is nothing to be worried based on the EKG and it does not show any bad readings. I had two EKGs done over the course of one month. I do not know why I get chest pain. Is it something related to do with the heart? If I had a heart attack or having one, it will be seen on EKG. Also, from the morning I have some sensation like a fluttering on the right-hand side of the chest. I am using an Apple watch to monitor my heartbeat and I noticed some spike in heart rate going to 141 beats per minute. But do remember each time I was either walking or climbing steps to reach a different floor, is this ok?

#

Hi,

Welcome back to icliniq.com.

Yes, ECG (electrocardiogram) will show the changes of the heart attack and normal ECG makes heart attack unlikely. So I think, you should not worry about it. And the heart rate spiked twice and is this fluttering correlate it with, or this is continuously occurring. If it is consistently happening, then it means it is not related to your heart rate. Your heart rate will go up with climbing stairs to this level. Also, the watch may also show false readings many times, so whenever your clock shows such elevated heart rate, then you may confirm it manually by counting pulse rate in one minute if possible. Why don't you use Alivecor Kardia monitor which can also show ECG tracings and will clarify the picture entirely? It is also portable, and you may wear it whenever you are at home.

Thank you doctor,

From the morning, there is a fluttering or some squeezing feeling on the right side of the chest. However, the spike is only occasional, not constant. Conclusive to tell there are no signs of heart attack. I will get the EKG done tomorrow and I will post it. I will also order an Aliveco Kardia device.

#

Hi,

Welcome back to icliniq.com.

There are multiple structures in our chest including lungs, pleura, food pipe, muscles, and bones. The most frequent problem which troubles many individuals is acid reflux which causes squeeze, chest and back pain, palpitations. It may be associated with chest burning, increase in symptoms on lying down, upper abdominal heaviness. Also, cardiac pain is unusual on the right side. Even, if fluttering is due to heart, it is not a sign of heart attack and not life-threatening, so it is not worth worrying. Next, it can be musculoskeletal due to repeated intercostal muscles contractions, so try to press over the chest and bones if it causes any tenderness. Observe your chest wall during fluttering. With the symptoms, if you have EKG, then it is sufficient to rule out heart attack considering your background and current symptoms. So the possibility of heart attack is very low.


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