My heart rate increases with exertion. Should I be worried?

Patient's Query

Hi doctor,

I have a severe doctor phobia. I am unable to go in for care, but I need to understand something happening better and if it is normal for my health. I had an episode of something a couple of months ago. I got extremely sick, started vomiting and sweating horribly, has chills and massively severe pain in both breasts. That was so bad and could not even let my arms brush against them. It lasted a couple of hours and then I fell asleep. I was concerned at that time that it may have been a heart attack, but I am afraid to go for a check up.

I am a 45 year old female. I am overweight 270 lbs and have not been active for a while. I have started having my heart rate spike to 120 or 140 when I stand up and move. If I move much or fast, it goes to 150 or 160. I know my overall health is not good and I am trying to change that. I am trying to fix this with improving my lifestyle. Is it something serious to be worried about? My resting heart rate has been in the 80s if sitting calmly but can get into the low 70s, if I am resting or sleeping. Even moving in bed, increases my heart rate to 100s or 110s. I began using an oximeter to monitor the pulse rate and try to get data to understand and try to fix it. But, I realized that it keeps saying my oxygen is dropping. I have a picture of the readings from the oximeter information. I am drinking vegetable juices and taking supplements to thin the blood and help the heart to try to help. But, it has been several weeks, and it is not improving. I have been taking Hawthorn, Omega 3, turmeric, cayenne, magnesium or potassium aspartate and Aspirin for the last week.

Answer

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine

Hi,

Welcome to icliniq.com.

First of all, there is no need to worry and relieve your anxiety.

In all probabilities, you are having obstructive sleep apnea as all your data fits into it. Do you have any symptoms like snoring, interrupted sleep, unrefreshing sleep, morning headaches, daytime sleepiness, etc.? If yes, then it further supports the diagnosis.

Obstructive sleep apnea is a condition characterised by obstruction of upper airway especially during sleep due to lax airway and narrowing of airway due to obesity.

Obstruction of upper airway leads to temporary stoppage of respiration, increased sympathetic drive and increased pulse rate. Also, another reason for pulse rate rise is deconditioning as you are not accustomed to activities.

The investigation I suggest includes ENT examination if you have any symptoms of nasal stuffiness, recurrent tonsillitis to rule nasal causes of obstruction, thyroid function test, lipid profile, sugar, HbA1c and vitamin D.

I also suggest polysomnography, which is sleep study to confirm the diagnosis and extent of disease and pressure of CPAP (continuous positive airway pressure) needed.

In treatment, the first thing weight loss. You need to have low-fat and low-calorie diet to lose weight as a cure for this is weight loss.

Secondly, CPAP, which is mask and device and pressure of inspiration and expiration during sleep in order keep your airways patent and avoid this from happening.

Also, regular exercise is very important. Chest physiotherapy and yoga will be helpful. Visit nearby sleep specialist or pulmonologist and get the above investigations done.

Revert with the reports to a cardiologist online -->https://www.icliniq.com/ask-a-doctor-online/cardiologist

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Patient's Query

Thank you doctor,

I do have very mild sleep apnea, and for which, I use an auto-CPAP machine. I have been keeping data on, and I only have AVG two small apneas. The greatest fear is on the level of heart rate spikes when I move. I started recorded monitoring a couple of days ago and night time is very calm unless I change positions and then jumps over 100 for a few seconds. The moment I stand up it spikes to 130s and if I walk much or carry anything it increases. It is that the heart rate increase with exertion that is worrying me.

Answer

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine

Hi,

Welcome back to icliniq.com.

Listening to your conversation, history and age, it does not appear to be a serious condition. It does not look like a heart attack at all.

But, we cannot be sure unless a direct doctor visit and examination are done. You can visit a doctor, keeping in mind that nothing serious will come out.

Your concern is of heart rate. So, the first thing is to get an ECG done and then a Holter monitoring which is an ECG monitoring over 24 hours. This will erase all doubts. You can upload the reports.

According to the history, your heart rate increases on exertion, which suggests it is normal. But, excessive increase in heart rate can occur due to the condition which I mentioned earlier. Also, thyroid and hemoglobin test has to be done.