Heart Rate Issues After COVID-19: A Young Adult's Experience

Heart rate issues

Hello, doctor.
I am an 18-year-old male, 165 cm tall, weighing 62 kg, with a normal BMI and a regular exercise habit.
I have been diagnosed twice with COVID-19.
After recovering from the first diagnosis, I occasionally experienced tachycardia while at rest, with a maximum heart rate of about 150 bpm.
A resting electrocardiogram (EKG), blood tests for high-sensitivity cardiac troponin and thyroid hormones (TRH, TSH), chest X-ray, echocardiogram, and 24-hour Holter monitoring all showed no abnormalities.
I returned to normal activities with minimal symptoms.
Recently, after the second diagnosis, I again experienced occasional tachycardia.
When I rushed to the clinic during an episode, the doctor noted that aside from a heart rate of around 135 bpm, there were no significant abnormalities.
I still occasionally experience palpitations, but they usually resolve within a few seconds.
Just now, I injured my elbow and went to a traditional therapy center for treatment.
The therapist instructed me to lie down and exert maximum effort with my biceps against his resistance for about 20-30 seconds.
After the first treatment, my heart rate increased significantly due to the exertion.
I took deep breaths, filling my lungs completely before exhaling.
After exhaling fully, my heart rate dropped sharply, almost like a cliff, from over 120 bpm to what felt like around 55 bpm (as I couldn't measure it immediately, this is just an estimation based on my feelings).
After a couple of beats, my heart rate surged again, even faster than before.
I didn't think much of it, and after the second treatment, there were no particular abnormalities; my heart rate quickly returned to the 60s to 70s bpm range at rest.
However, the situation I just experienced was very unusual and unprecedented, so I wanted to ask a few questions: 1.
Could this be related to autonomic dysfunction as a post-COVID sequela? 2.
Or is this indicative of another abnormality? 3.
Is it serious, and could it affect my ability to exercise? 4.
If I experience similar situations in the future, would taking Inderal, as prescribed by my internist, conflict with N-acetylcysteine (NAC), the herbal remedy bamboo shavings, and the herbal remedy Coptis? How long should I wait between taking them? Thank you for your response.

Niming Fawen, 10~19 year old female. Ask Date: 2023/04/17

Dr. He Dongjin reply Cardiology

Hello, post-COVID sequelae include autonomic nervous system dysregulation, which does not affect exercise.
It is safe to take Inderal with two other medications; there is no conflict, and you can take them at any interval.
Changhua Hospital cares about you.

Reply Date: 2023/04/17

More Info

Hello! Thank you for sharing your experience and concerns regarding your heart rate issues following COVID-19. It’s understandable to feel anxious about these symptoms, especially after experiencing two infections. Let’s break down your questions and provide some insights based on current medical knowledge.

1. Could this be related to post-COVID autonomic dysfunction?
Yes, it is possible that your symptoms are related to autonomic nervous system dysfunction, which has been observed in some individuals after recovering from COVID-19. The autonomic nervous system regulates involuntary bodily functions, including heart rate, blood pressure, and digestion. Post-viral syndromes, including those following COVID-19, can lead to dysregulation of this system, resulting in symptoms like palpitations, increased heart rate, and even episodes of dizziness or lightheadedness. This condition is sometimes referred to as postural orthostatic tachycardia syndrome (POTS), which can cause an exaggerated heart rate response to changes in posture or activity.

2. Could this be indicative of another abnormality?
While your tests (EKG, echocardiogram, blood tests) have returned normal results, it’s essential to continue monitoring your symptoms. The heart rate increase you experienced during physical exertion (like during your therapy session) is a normal physiological response. However, if you notice persistent or worsening symptoms, it would be prudent to consult with a healthcare provider to rule out any underlying conditions that may not have been captured in your previous tests.

3. Is this serious, and will it affect my ability to exercise?
Generally, if your heart rate returns to normal after episodes of increased heart rate and you do not experience other concerning symptoms (like chest pain, severe shortness of breath, or fainting), it is likely not serious. However, it is crucial to listen to your body. If you feel unwell during exercise or experience significant heart palpitations, it may be wise to reduce the intensity of your workouts and consult with a healthcare provider. They can help tailor an exercise plan that considers your current condition and any limitations.

4. Regarding the use of Inderal (propranolol) and potential interactions with herbal remedies:
Inderal is a beta-blocker that can help manage symptoms of anxiety and palpitations by slowing down the heart rate. If you are considering taking Inderal, it’s essential to discuss this with your healthcare provider, especially regarding potential interactions with herbal medications like N-acetylcysteine (NAC), bamboo leaf (Zhu Ru), and Coptis chinensis (Huang Lian). While there is limited research on specific interactions between these herbal remedies and beta-blockers, it is generally advisable to space out the administration of different medications and supplements. A good rule of thumb is to wait at least 2 hours between taking different substances, but this should be confirmed with your healthcare provider.

In conclusion, while your symptoms may be concerning, they are not uncommon in individuals recovering from COVID-19. It’s essential to maintain open communication with your healthcare provider, monitor your symptoms, and adjust your lifestyle as needed. If you experience any new or worsening symptoms, do not hesitate to seek medical attention. Remember, your health and well-being are the top priority!

Similar Q&A

Managing Rapid Heartbeat After Omicron: Tips for Recovery at Home

I am a confirmed COVID-19 patient, and it has been about ten days since my diagnosis. When I lie down and relax, my heart rate is around 60-80 beats per minute, but when I get up to drink water or sit, my heart rate spikes to about 120, then gradually decreases. If I remain seate...

Dr. Wang Lanfeng reply Pulmonology
Hello: Based on your description, your condition may be a post-viral syndrome resulting from a coronavirus infection. Currently, some hospitals have established integrated outpatient clinics for COVID-19. It is recommended that you seek medical consultation. Thank you.

Understanding ECG Interpretation After COVID-19 Recovery: Your Concerns Addressed

I was diagnosed on May 15 and am currently recovering. Recently, I have been experiencing left chest tightness and am worried about a myocardial infarction. On the evening of June 13, I went to the cardiology department for an electrocardiogram, and the doctor said it was normal....

Dr. Wu Xueming reply Cardiology
This medication will slow down the heart rate but will not affect the interpretation of the electrocardiogram (ECG).

Assessing Heart Health During COVID: When to Seek Medical Attention

Hello doctor, given the current tense pandemic situation, I am concerned about occupying hospital medical resources. What symptoms should I pay attention to that would require a follow-up visit, or how should I assess my condition based on your recommendations? I have been experi...

Dr. Wu Xueming reply Cardiology
Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages. It is advisable to adjust your lifestyle and engage in regular exercise. A heart rate between 60 and 100 beats per minute...

Understanding Rapid Heart Function Decline After COVID-19: A 23-Year-Old's Journey

Hello Doctor, I am 23 years old. My 24-hour Holter monitor showed only 6 instances of atrial premature contractions (APC) and ventricular premature contractions (VPC). I have a slight mitral valve regurgitation, and my echocardiogram showed that my left ventricular ejection fract...

Dr. Huang Yinghe reply Cardiology
Hello: The results of the echocardiogram for LVEF may vary slightly each time, but a decrease from 70% to 50% could indicate a new issue. I cannot determine whether there is a problem or if it is related to your COVID-19 infection last year; this requires an overall assessment by...