Elevated Heart Rate: Causes and Concerns for Patients - Cardiology

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Elevated heart rate, or tachycardia, can be a concerning symptom for many patients, especially when it occurs suddenly or without an obvious cause. In your case, experiencing a heart rate of 103 beats per minute (bpm) upon waking, which increased to 117 bpm at the hospital, can be attributed to several factors, including anxiety, physical activity, and environmental changes.

Causes of Elevated Heart Rate:
1. Anxiety and Stress: It is well-documented that emotional states such as anxiety can significantly affect heart rate. The anticipation of a medical appointment, especially if you are prone to nervousness, can trigger a "fight or flight" response, leading to an increase in heart rate. This is a normal physiological response as the body prepares to deal with perceived threats.

2. Physical Activity: If you were moving around or engaging in any physical activity before measuring your heart rate, this could also explain the elevation. Even minor movements can temporarily raise your heart rate.

3. Environmental Factors: Changes in temperature, humidity, or altitude can influence heart rate. For instance, hot weather can lead to vasodilation (widening of blood vessels), which can increase heart rate as the body works to maintain blood pressure.

4. Medical Conditions: Conditions such as anemia, hyperthyroidism, or infections can also lead to an elevated heart rate. However, since you have a history of mitral valve prolapse, it’s essential to monitor for any additional symptoms that may indicate complications.

5. Medications and Substances: Caffeine, nicotine, and certain medications can also elevate heart rate. If you consumed any of these before your measurements, they could be contributing factors.

Concerns Regarding Mitral Valve Prolapse:
Mitral valve prolapse (MVP) is a condition where the valve between the heart's left atrium and left ventricle does not close properly. While MVP is often benign, it can sometimes lead to complications such as arrhythmias or, in rare cases, infective endocarditis (heart valve infection). Your concern about the risk of endocarditis, especially after dental procedures, is valid. It is generally recommended that patients with MVP take prophylactic antibiotics before certain dental procedures to prevent endocarditis, particularly if there are additional risk factors present.

Recommendations:
1. Monitor Symptoms: Keep track of your heart rate and any accompanying symptoms, such as chest pain, shortness of breath, or dizziness. If you notice persistent tachycardia or any concerning symptoms, seek medical advice.

2. Manage Anxiety: Consider techniques to manage anxiety, such as deep breathing exercises, meditation, or talking to a mental health professional. Reducing anxiety can help lower your heart rate.

3. Follow-Up with Your Doctor: Given your history of MVP and recent symptoms, it would be wise to discuss your concerns with your healthcare provider. They may recommend an echocardiogram or Holter monitor to assess your heart function and rhythm over time.

4. Dental Care Precautions: Inform your dentist about your MVP and discuss whether you need antibiotics before dental procedures. This is particularly important if you experience any dental work that could introduce bacteria into your bloodstream.

5. Lifestyle Modifications: Maintain a healthy lifestyle with regular exercise, a balanced diet, and adequate hydration. Avoiding stimulants like caffeine and nicotine can also help manage your heart rate.

In conclusion, while an elevated heart rate can be concerning, it is often a response to anxiety or environmental factors. However, given your medical history, it is essential to remain vigilant and consult with your healthcare provider for personalized advice and management strategies.