What is the influence of cocaine on heart rate?

Hello doctor,

For the past two months, I have had a pretty consistent elevated heart rate. Not by a lot but noticeable for me compared to what I was coming from. I cut out alcohol and caffeine and that helped but it always returns. My resting heart rate (I wear an Apple watch) is pretty consistent in the 53 to 58 bpm range. But when I get up, go up or downstairs, it will jump to 100 pretty fast, then average out in the 80's as I move about my day. When I am sitting at work it is 78 to 85 bpm. This is a good 8-10 bpm faster than when I am at peak health. I am not sure what is going on. I did a fair bit of cocaine and took some ED pills a few times (with the cocaine) before three months, so I wondered if maybe there is a connection. I have not done anything like that since then. I am a runner, but now when I run or jump it goes up to 150 bpm and higher pretty fast. If I push myself anywhere close to hard I am at 170 to 180 bpm pretty easily, so I slow down. And it seems my body does not recover quite as fast. So I have stopped running hard and just do light jogs, and play tennis. I recover pretty easily there. But it is annoying as I want to run and push myself. I will go two to three days with no caffeine, alcohol and then I notice my walking around rate is lower, like what it used to be mid 70's. When it is like that I can feel it noticeably, I feel much more complete and whole. I feel great and no shortness of breath. So then I will have a few glasses of wine that night, and maybe a dessert (I like sugar at night) and I will lay down to sleep and my heart seems to jump up to 85-95 bpm for a while and it takes two to three hours before it rests at 53 to 58 bpm. And then the cycle starts again. I am so confused I do not know what the deal is. Is it the alcohol or sugar? I drink this one type of white wine a lot but I have noticed my heart rate does not react as much when I just drink beer. One night, I had white wine then tequila and my resting rate was like 68 to 78 bpm all night. I saw a doctor about three weeks ago and they did an ECG and listened to my heart and it showed no issues or irregularities. I do not have heart pain, though I did have a few sharp pains over the past two months maybe two to three times all lasting about one second and then it is gone all when I am lying down in bed trying to go to sleep. I do have shortness of breath due to the elevated heart rate when I am carrying stuff, going upstairs, etc. I do not have pain in my chest, jaw, left arm, etc. Sorry, this is so long but I really would love to discuss this with someone who maybe has heard of this before. To be clear what is annoying and confusing me is that my heart rate will steadily be 8 to 10 bpm higher at all times (aside from resting rate) for like a seven to ten days before it feels like it goes back to normal. But then there is always something that sets it off again. I never see it spike over 105 or so.

Thank you doctor,

I know it is normal for HR (heart rate) to fluctuate but my question is why is it normal for a few days and then it is consistently higher for up to a week? That is not fluctuating in my opinion. Like yesterday, it was the first day it was lower when I sit and work in the 65 to 70 bpm range. Today (and probably for the next seven days) it is 75 to 80 bpm. When I used to run I would not hit 180 bpm like I do these days. How can you explain that? I understand anxiety is a factor perhaps. But these numbers I am giving you are very real numbers. When I was sitting on the couch last night watching TV, my HR was 65 to 70 bpm then I go upstairs to sleep and lay down and it is 85 to 95 bpm, for a while before it goes down. Are you saying that is all anxiety? Is it possible I had a very small heart attack before months and my heart is still affected by it? Tell me, you say to run again and it will help my situation. What do you mean exactly, how will that help me?