Why is the heart rate fast despite regular echocardiograms?

Question

Hello doctor,

I am a 38-year-old female who has recently been having very fast heart rate episodes. This has been happening on and off for the past ten weeks. When it happens, it comes on suddenly, and my heart rate goes up to 165 bpm. It is very frightening. I have been to my doctor twice, but he thinks it is anxiety, and he gave me Propranolol 80 mg modified-release capsules to take every day. My heart rate is acceptable when I take them, and I feel calm. I am scared if it is not anxiety and something severely wrong with my heart. I had two echocardiograms last year, which were normal. The cardiologist said nothing was wrong with my heart and that I should not worry. I am a very anxious person, and I worry all the time lately. It has been getting worse and more severe. I do not know if this fast heart rate is anxiety or if there is something seriously wrong with me.

I was going out of my mind, worried and scared to live my life. I was taking my daughter to school today, and my heart started racing out of nowhere. I took a Propranolol 40 mg straight away, but my heart rate went up, down, and up again. I am honestly terrified if there is a problem with my heart. I feel shaky and dizzy with a dry mouth, too, when it happens. I have had a complete blood count, and the levels are normal. My blood pressure is also normal. My doctor referred me to a heart specialist, and I saw him last week. He said I had four normal echocardiograms in the previous two years and a stress treadmill test.

The reports were normal and said if anything were wrong with my heart, these tests would have shown something. He said that I have extreme anxiety and that nothing is wrong with my heart, but I am terrified if I have a problem. I am scared to leave the house and have no life now. I cannot go out and enjoy myself as I am afraid of having a fast heart rate when I am out, and I will have a stroke or heart attack. He did all blood tests, which were normal, but I was unsure about this cholesterol blood test result. I am just going out of my mind with worry as the fast heart rate is happening almost daily. I have enclosed a copy of the echo result. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I would like to know how often you have such fast heart rates. If it occurs daily, get an ECG (electrocardiogram) done when you have palpitations. If it happens every day but episodes last for brief periods, get a Holter monitoring done. It can just be sinus tachycardia due to anxiety or supraventricular tachycardia (SVT), which is also very common in young females. SVT is not a dangerous thing. It is treatable and, in most cases, curable. If you have already completed an ECG (electrocardiogram), send it to me.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

In supraventricular tachycardia, echocardiography is normal. However, I suggest you do an ECG or electrocardiogram when you have fast heart rates. This will clarify the cardiac rhythm issue. From echocardiography (attachments removed to protect the patient's identity), it is clear that you do not have any structural heart abnormality, so there is no need to worry.

I hope this helps.

Please revert so I can assist you further.

Thank you.