Strange heart rhythm when exercising & after eating.

Patient

Q: Hello, I am writing this out of desperation at this point. I have seen multiple doctors over a span of about 4 years and have yet to find a conclusion. In fact, almost every doctor runs one or two tests and takes my bloodword before finding nothing unusual and simply acts like I am fine and does not try to look into anything further. I can tell you that there IS something off, whether it is serious or not I need to get this figured out. I am really hoping that someone might be familiar with my symptoms and be able to offer some sort of insight.

I am 26 years old, 5'5" and weigh 117 pounds. I am married and have an 11 month old son. I have been healthy my entire life. I grew up hardly ever getting sick and played 5 sports at a competitive level. I ran track, played soccer, basketball, tennis and volleyball. I was one of the fastest on all of my teams and could run all day long. I loved exercising. I have not drank soda for about 10 years now, and do not drink coffee.

About 4 years ago I started having odd symptoms. I would get terrible headaches, random nausea, severe fatigue and often times I would faint or feel faint. I could still go to the gym and workout, or go for runs and bike rides with no problem as long as I was not experiencing these symptoms, which seemed to come randomly. I also was no longer able to have a glass of wine at dinner because my heart would start racing and I would feel very dizzy, faint and foggy after just one or two sips. The same thing happens with coffee... I was in and out of the hospital due to fainting spells and feeling very sick all of the time. However, when I would go to the ER, they would always take my blood work and it was always normal besides an elevated white blood cell count. In fact, I almost always felt fine once they finally saw me, but an hour before I could not walk or see very well, let alone have a normal conversation because my speech was very slow and slurred.

About a year later, my symptoms became worse. I was no longer able to workout at a moderate level of intensity because my heart rate would shoot up extremely high and I would feel the blood rushing to my head and have to lay down. At this point my vision would be foggy. Once I would lay down to rest, my heart rate would almost immediately decrease to incredibly slow rates to where I could barely stay awake, and once again, the speech became very slow. Other times my heart rate would remain at a fast pace for over an hour and sometimes 2 hours. I would try to calm myself down by taking a warm bath and listening to soothing music, but nothing, not even slow deep breaths could calm my heart rate. Also, I could not even go grocery shopping alone because similar symptoms would occur just walking around and I would have to sit down in the middle of the aisle with my head between my legs waiting to feel well enough to walk to the car. So my husband would always accompany me but 9 out of 10 times, I would have to sit down in the middle of the aisle and so it was just pointless for me to continue going.

I was still seeing various doctors for these symptoms who could not figure anything out. One doctor tested me for lupus, and I showed a positive screen but then further tests showed nothing unusual besides an elevated white blood cell count like before. This particular doctor felt that I had an underlying auto immune disorder but I ended up moving due to my husband's military career and had to start fresh with a new doctor who did not seem very concerned. At this point, I was getting sick often, and staying sick for long periods of time. I would get the cold or the flu, and remain sick even after taking antibiotics for months. One time it grew into pneumonia.

Then I became pregnant, and was very worried. It was not a planned pregnancy because I did not feel comfortable with my health to carry a child but for whatever reason I felt much better throughout my pregnancy besides one problem: The issue that I had while exercising became exponentially worse. At this point, I could not walk from the car to my room without having a racing heart rate of over 190 (which even when I was healthiest and working out at my hardest level on the elliptical, I could not reach that heart rate) This caused many more ER visits because my husband and I were concerned about the baby. Each time my husband would have to carry me in because I was unable to walk, and I could barely talk. My heart rate would always get into the 190s and then suddenly drop to being incredibly slow and I would struggle to stay awake. This would usually last about 15-30 minutes and then I would almost instantly be fine.

I was referred to a cardiologist who had me wear a heart rate monitor for 72 hours. The monitor showed my heart rate reaching the 190s multiple times but the cardiologist said that she thought it was due to my hormone levels from pregnancy and a chemical inbalance and not a heart issue. She said that once I had the baby that I should get my blood tested for this problem. Well I had my healthy baby boy in November of 2013 and after that I was able to walk for 3 miles and even workout at a moderate level just fine. However, if I attempted a more difficult exercise, the same thing would happen with my heart rate and I would become very tired as soon as my heart rate slowed down. I mentioned what the cardiologist has suggested and the doctors had no idea what I was talking about. At this point I have even forgotten the blood test she had recommended. The doctors took my blood test and said everything was just fine, like always but still showed an elevated white blood cell count.

Now, I can still walk around the neighborhood, or walk up stairs and do mild workouts without a problem but as soon as I attempt any type of exercise that causes me to sweat a little bit, I have the same problem. I have to stop my workout because I have what I call a black foggy vision (like there is a bunch of pepper around the edges of my eye sight) and if I do not stop and sit down it feels like I will pass out. Once I sit down, the problem does not subside, and remains the same. If I lay down on my back and usually put my arms over my head, then it will very slowly over a matter of about 20-30 minutes get back to being normal.

Almost every time I am done eating, I become extremely tired as well. I thought that it was bread that was the trigger but then after I would have something like a virgin lava flow (we live in hawaii where my husband is stationed and they are so delicious....they are pina colada drinks with strawberry syrup) I would almost immediately have the same issue and also even become extremely full and nauseous, ruining my appetite before I even began to eat even though I was extremely hungry right before the drink. This was just an example, I have probably had 3 of these drinks over a matter of a year of living here. Other times it will be Greek yogurt that triggers it, or this morning I had a gluten free waffle with organic maple syrup. Other times it will be cereal, or spaghetti. If I eat chicken, my stomach feels like it is starving and even though I had a big meal (brown rice, grilled chicken with olive oil, garlic salt, rosemary and pepper and some veggies cooked with olive oil and some seasoning) within about 30 minutes to an hour, I feel like I have not eaten all day long and my stomach hurts (mildly though.... just uncomfortable) I seem to be fine if I have a big juicy steak with mashed potatoes and green beans. I also seem fine if I have a few eggs with some cheese for breakfast or oatmeal with blueberries.

Every day, even though my son sleeps for long periods of time, usually giving me 6-8 hours of sleep, I wake up feeling extremely tired and remain tired all morning until I eat something which then usually triggers a stronger sense of fatigue. I sometimes have to take a nap after only being awake for an hour.

Right before I became pregnant, I was not drinking enough water and we were not eating very well because we were struggling with bills and had to frequently resort to frozen pizzas and top ramen. I thought that this was the reason for my symptoms back then but once I became pregnant, I was even taking a log to make sure that I was eating enough greens, fruits, grains, protein and drinking more than enough water and I still had this problem. It is getting to the point where I desperately want to workout but can not. If I carry my son up a high amount of stairs, I feel as though I will pass out. I am 117 pounds, and 5'5". Next year, we plan on having a second baby but I need to get my health figured out before then otherwise I will continue to have the same issues and not be able to exercise which is not good for the baby or myself.

Recently, I saw a gastrointestinal specialist and he thought that I might have IBS....however I do not see how that could be the source of the problem I am having with my heart. He was not sure about that either. So here I am.... reaching out in hopes that someone might have an idea of what this might be. I am worried that one day something might happen because we could not figure this out sooner. I need to be healthy for my children and for myself. I want to be able to run around with my son and throw a football with him or play soccer with him without fainting or having to sit out after 30 seconds of simply running from one end of the field to the other.

Symptoms:  Symptoms: Feeling faint, fainting, fast heart rate, very slow heart rate, fatigue, elevated white blood cell count, fatigue after eating
Doctor

A:   Thank you for your question

There is no immediate diagnosis that sticks out but it is important to rule out the worst possible causes and try alternative treatments until a diagnosis can be found

In terms of possibilities, inflammatory conditions such as lupus and rheumatoid arthritis have to be considered. When blood tests are normal or weekly positive but the symptoms are severe, it is reasonable to go on a trial of medication. The ideal choice would be methotrexate or prednisone and results would be noticeable within a month.

Cancers always have to be considered and the only cancer capable of producing a wide variety of symptoms would be a carcinoid tumour. These are hormone producing gastrointestinal tumours that are detected via a CT scan of scope.

Lastly, heavy metal posoining has to be considered and can be detected through blood tests for heavy metals and other toxins.

While the above theories are being investigated, I sometimes recommend seeing a naturopath or osteopath as a trial

I hope this was useful

Comments / Follow Ups

Doctor: Thank you for your question

There is no immediate diagnosis that sticks out but it is important to rule out the worst possible causes and try alternative treatments until a diagnosis can be found

In terms of possibilities, inflammatory conditions such as lupus and rheumatoid arthritis have to be considered. When blood tests are normal or weekly positive but the symptoms are severe, it is reasonable to go on a trial of medication. The ideal choice would be methotrexate or prednisone and results would be noticeable within a month.

Cancers always have to be considered and the only cancer capable of producing a wide variety of symptoms would be a carcinoid tumour. These are hormone producing gastrointestinal tumours that are detected via a CT scan of scope.

Lastly, heavy metal posoining has to be considered and can be detected through blood tests for heavy metals and other toxins.

While the above theories are being investigated, I sometimes recommend seeing a naturopath or osteopath as a trial

I hope this was usefull

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