Rapid Heartbeat and Low Blood Pressure: Your Symptoms

Tachycardia with hypotension?

I have low blood pressure and body temperature, but my heart rate often exceeds 100 beats per minute (even during normal activities without exercise).
Today, I visited a clinic due to an allergic reaction on my face that caused a rash.
When the nurse measured my blood pressure, the device initially couldn't detect it.
After switching arms, my heart rate was 123 bpm, blood pressure was 99/78 mmHg, and my temperature was 35.6°C.
The doctor noticed my elevated heart rate and asked if I was experiencing any discomfort.
Honestly, I didn't feel unwell at that moment; I just felt itching and pain on my face.
The doctor inquired about any history of heart disease.
I was diagnosed with arrhythmia at 18 and underwent catheter ablation.
Since then, I have experienced chest tightness and difficulty breathing, but no cause was found, so I haven't pursued further follow-up.
Currently, I feel fatigued and often feel like I am not getting enough sleep.
At night, I don't sleep deeply, as I sometimes experience tinnitus and can hear my heartbeat, which feels strong enough to shake my body (during these times, I feel pressure and chest tightness).
Occasionally, I feel like my heart skips beats (the normal rhythm suddenly misses two beats), which leaves me feeling weak.
Therefore, my sleep is not very restful.
I would like to ask the doctor whether I should see a cardiologist or another specialist for these issues.
The clinic doctor suggested that I undergo cardiac and blood tests.
Additionally, I have a slight anemia issue, with an average red blood cell volume of 73 and an average hemoglobin concentration of 24.5.
Thank you, doctor.

Yang Xinyi, 30~39 year old female. Ask Date: 2016/11/17

Dr. Lin Jixiong reply Cardiology

It is recommended to have a consultation at the cardiology outpatient clinic.

Reply Date: 2016/11/17

More Info

Based on your description of symptoms, including a rapid heartbeat (tachycardia) and low blood pressure, it is essential to understand the potential implications of these signs and whether further medical evaluation is necessary.
Firstly, a resting heart rate above 100 beats per minute is classified as tachycardia. While this can occur in response to various stimuli such as stress, anxiety, fever, or even allergic reactions (as you mentioned with your facial rash), it can also indicate underlying cardiovascular issues, especially given your history of arrhythmia. The fact that your blood pressure was recorded as 99/78 mmHg, which is on the lower side, combined with a high heart rate, can be concerning. This combination may suggest that your heart is working harder to maintain adequate blood flow and oxygen delivery to your organs, which can lead to symptoms such as fatigue, dizziness, or even fainting.

Your previous diagnosis of arrhythmia and the surgical intervention you underwent (likely catheter ablation) indicate that you have a history of heart rhythm issues. Although you may not currently feel discomfort, the presence of symptoms such as palpitations, a sensation of missed heartbeats, and feelings of pressure or chest tightness should not be ignored. These could be signs of a recurrence of arrhythmia or other cardiac conditions.

Additionally, your mention of fatigue and poor sleep quality, along with the sensation of hearing your heartbeat and experiencing ear ringing (tinnitus), could be related to anxiety or stress, but they may also indicate a more complex interplay between your cardiovascular health and overall well-being. Sleep disturbances can exacerbate feelings of fatigue and may contribute to a cycle of anxiety, which can further elevate heart rates.

Given your history of anemia, as indicated by your low hemoglobin levels, this could also play a role in your symptoms. Anemia can lead to decreased oxygen delivery to tissues, which may cause your heart to compensate by beating faster. The average red blood cell volume and hemoglobin levels you provided suggest that your body may not be adequately oxygenated, which can lead to fatigue and other systemic symptoms.

In light of these factors, it is advisable to consult a cardiologist for a thorough evaluation. This should include a detailed history, physical examination, and possibly further testing such as an electrocardiogram (ECG), echocardiogram, or even a Holter monitor to assess your heart rhythm over a 24-hour period. Additionally, blood tests to evaluate your hemoglobin levels and other markers of cardiac health may be warranted.

In summary, while your current symptoms may not seem alarming, the combination of tachycardia, low blood pressure, and your medical history necessitates a careful and thorough evaluation by a healthcare professional. It is better to err on the side of caution, especially with a history of heart rhythm issues. Seeking a cardiologist's opinion will help clarify the situation and guide you toward appropriate management and treatment options.

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