What causes persistent tachycardia despite normal tests?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have reviewed your ECG (Electrocardiogram) in detail. It shows:

1. Sinus tachycardia (fast heart rate from the heart’s natural pacemaker).

2. Rhythm is regular; each QRS complex (main heartbeat spike) is preceded by a P wave (atrial activation). Heart rate is around 120 to 130 bpm (beats per minute).

3. Axis, PR interval (start of atrial to ventricular activity), QRS duration (ventricular contraction), and QT interval (ventricular contraction and recovery) are all normal. ST segments and T waves (recovery phase) appear normal, with no signs of ischemia (restricted blood flow).

4. With a normal echo (echocardiogram) and no structural disease, this is reassuring, but persistent tachycardia on standing should be evaluated.

5. Check for POTS or Postural Orthostatic Tachycardia Syndrome (a condition where standing causes an excessive rise in heart rate (over 30 bpm) without a blood pressure drop, leading to dizziness and palpitations).

6. Measure HR (heart rate) and BP (blood pressure) lying and after standing; a rise of>30 bpm without a BP drop suggests POTS.

7. Rule out causes: TFT (thyroid function tests: T3, T4, TSH) for thyroid issues, CBC (complete blood count) for anemia, electrolytes, and Vitamin B12.

8. Consider 24-hour Holter monitoring (a 24-hour portable ECG test that records heart rhythm continuously to detect irregularities missed by a standard ECG) to track heart rhythm.

Meanwhile, drink 0.5 to 0.7 gallons of water, add salt if BP is normal, avoid caffeine and smoking, and start gentle exercise.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.