Cardiology

[Smurf123]

Hi so I have been having issues with tachycardia and high resting heart rate for a few months after a virus/ likely covid. I was admitted for a night and had a chest ct incase of pe. Heartrate is still high though not quite as high - not as constantly high. I'm tired constantly, feel run down, nauseous, weight loss, palpitations come and go.

I did have a 24 ecg and the letter from it states that it showed sinus tachycardia and I was referred for a further cardiology appointment. I felt unwell over the weekend and when I looked at my fitbit it showed hr at 51 (I was watching TV in bed) its never that low so I checked the app which showed it had spiked at 214 (it's never been this high) before plummetting to 51 where it stayed for about 15 mins before returned to the 90s.
Gp still isn't happy and has writteb another referral but also asked me to phone and check on the status of the appointment - I did this and was told they are working through a backlog of appts and it could be another 4 years! I can't afford to go private. I'm early 30s never smoked blood pressure is low usually healthy and active and this has floored me. I do have b12 deficiency and get injections every 3 months. Anyone have any experience? Is it possible it's still post viral /long covid? Any tips on improving things?

Try taking magnesium, 100% rda every day at bed time. Vit D 2000 iui daily until the summer. Have you had your thyroid levels checked and iron/ferritin.

Those are the things I can think of immediately that might help. Lastly are there ways around the backlog (I dont know the NHS system well at all) like going to a different area of the UK with a shorter wait list, are you able to afford a single private assessment with a cardiologist so that you skip the initial wait and then go back onto the NhS for any tests recommended (usually about 200 pounds)

I'll try magnesium thanks
Thyroid and ferritin checked - all in normal range. Tsh 0.6ish and t4 - 21
Ferritin 80 I think
Iron 15
Transferrin saturation 22%

I did look at that but it said that if you needed additional tests normal nhs waiting list would apply so not ig it's worth it as it would be a stretch to even do the initial appt

what is your diet and lifestyle like, how much coffee do you drink, any recreational drugs, are you well hydrated normally, do you have any other medical conditions, do you have a family history of any particular disease and in particular heart problems? Just trying to see if there might be anything I could point you in the direction of while you wait to see the cardiology team

@SeaToSki no coffee, no drugs, don't smoke, rarely drink. Generally just black tea, water and occasional can of coke or lucozade if I'm feeling sick or really tired to try and get through the day.

Dairy free due to intolerance
Asthma normally mild and well controlled
Have been having some investigations but gastro for ibs type symptoms

B12 deficiency and have had folate deficiency on and off for years currently in normal range around 3.5

Normally fairly active lifestyle, active job currently not able to do it. 2 young kids.

No family history of heart issues, angina a few different cancers in grandparents but that's all

have you been taking asthma steroid inhalers over the years or any other steroids (like creams for eczema etc) . Long term use of them can cause side effects similar to those you are reporting

I have a brown inhaler but I'm on a very low dose and tbh am not great at taking it unless I'm having a flare up.
I did one of those blood health checks and just got results back from that which has showed borderline low sodium levels 133mmol and borderline high ldl levels

When I was admitted into hospital for the possible pe with the high heartrate when this all started i needed a potassium infusion as it was low too. Haven't had those levels checked since -not sure if it's relevant

Hmmm. have a google of Addisons disease with tachycardia and bradycardia. Sometimes people who have it chronically but at low levels can be pushed into more of a symptomatic situation by a virus that hits the body hard etc

Thyroid and ferritin checked - all in normal range. Tsh 0.6ish and t4 - 21

Hmmm. You could do with getting FT3 checked as well as FT4, because that FT4 value is right at the top of the range which is 12-22 if I recall correctly, can you check your labs? Also the TSH is dipping quite low, maybe you are developing hyperthyroidism. Maybe. You'd need to have FT3 tested, though. Hyperthyroidism will give a fast heart rate, amongst other things, best to have it ruled out. You could get a test kit from Medichecks or other companies that test TSH, FT4 and FT3.

@SeaToSki a lot of the symptoms of addisions are similar to what I have currently. I don't really have the skin pigmentation though. I have had a rash on my legs on and off for years that go has said looks like coeliac rash but coeliac bloodtest was negative.

@CrunchyCarrot yes tsh reference level is 0.27-4.2
And t4 12-22
I remember thinking tsh was very near the low end of its range and t4 at the top of its but gp said they are fine within normal range.

Yeah they often say that, but you really need to get the FT3 value to see what's going on. If that's also high, then Houston we have a problem.

Some people have Addisons without the skin pigmentation. I think given your lowish sodium levels its worth investigating, even if its just to rule it out.

Ok so I'll ask for a t3 test and about addisons - t3 I could pay for online but addisons I'm assuming has to be through gp

Good idea, good luck

For Addisons your first test needs to be a 9am cortisol blood . If you did want to consider private it may be worth just having an initial consultation which should be £2-300 and seeing if they will put you on their NHS books for any investigations ( make sure you book a cardiologist that works in the NHS , it usually says on the profile ) .

So I paid for thyroid check through randox
And a cortisol blood test through medichecks - home finger prick test at 9am

Thyroid all came back normal range and antibodies negative

Cortisol just back today and it says low. It's 126

I've tried booking a gp appt but earliest phone appointment is likely next Friday as they were all gone today we can only book a week in advance

Can you afford to see and endocrinologist privately as that may well be the way to go . 126 for 9am is low .

What were your actual results and ranges for the thyroid labs, @Smurf123 ?

I'm a nurse who previously worked in cardiology. I noticed a previous poster mentioned magnesium supplements. I would be wary about taking magnesium if your levels are already within range as this can cause arrhythmias and hypotension. You also stated that you had a potassium infusion when you were last admitted. I would ask your GP to check these levels again. I'm surprised they haven't checked them regularly. Potassium plays a huge role in heart health. I would keep contacting your GP as they may be able to hurry the referral along if you keep hounding them. Your heart rate spiking into the 200's is dangerous, especially at rest. If this happens again you need to get to hospital straight away.

Do you have any light headed/fainting/dizziness from going from sitting/laying to standing? Or lifting arms above head?

Any mottled blue legs hands if you stand still for short period of time?

My dd 16 has recently been diagnosed with Dysautonomia/POTS, sinus tachycardia and postural orthostatic after getting covid at the start of the first lockdown apparently cardiology said they have seen alot of it since covid

She has all the symptoms you mentioned plus more. Her current treatment plan to avoid beta blockers is 3x the recommended daily allowance of water and salt

@Killerqueenie I don't think potassium has been checked again since.
My gp also tells me to go to A&E when it spikes and I'm feeling awful which I do hear. But it doesn't stay up that high for long usually. It spikes then falls. According to my fitbit my sleeping heartrate last night was 82bpm. It's been between 99 and 130 the majority of today. Currently at 97. My head is thumping, paracetamol haven't done anything and I've had a couple of light headed spells earlier but they have passed again now.
Have another appointment with the ambulatory cardiology clinic next week after gp insisted.

@calderdale I've not fainted but had lots of light headed/ dizzy spells.
My finger and toe nails I've noticed with a blueish tinge.
I've been really thirsty / dry mouth recently and have been drinking more as it is.. The only result is constantly needing the toilet!

@CrunchyCarrot I've attached it
Though when I had it done at gp a month ago my tsh was 0.6 that was November time I think it's now 2.24 which seems like a big difference but either way both are normal range

I had similar episodes of inappropriate tachycardia, also unexplained. My heart rate would be 132 brushing my hair, 117 stood cooking, shot up when I did anything minimal, I could barely shower for a while, had to crawl upstairs. Couldn't work. Escalated following a Covid vaccine. Tilt table test for POTS negative. All bloods ok.
I then had a period of fast AF for which I eventually had an ablation and things more or less settled after that. I now take a low dose beta blocker but still have ectopic beats every day.
It's very debilitating. Is your heart rate regular?
I'm afraid I did go private as simply couldn't function.
I was told if heart rate was consistently over 100 at rest to go to A&E.