Rash and Rapid Heartbeat in Elderly Patients: What to Know

Widespread rash and a heart rate of 160 beats per minute?

Hello, my father is 81 years old and has been experiencing constipation.
He has had nasal polyps for many years, and over the past year, he has often had dry mouth and a bitter taste.
On the morning of September 19, he developed numerous red rashes below his waist, with both small and large spots, and a few red rashes on his upper body as well.
He visited a dermatologist who diagnosed it as urticaria (hives).
After taking medication, the rashes have not resolved as of September 21.
Additionally, on the morning of September 20, he suddenly felt dizzy and unwell.
He checked his blood pressure and found that his heart rate was as high as 160 beats per minute, with a systolic blood pressure of 70.
He then lay down to rest until his heart rate decreased to about 140 beats per minute before going to a nearby internal medicine clinic.
After taking the medication prescribed by the doctor twice, his heart rate finally returned to a normal range of 70-80 beats per minute.
However, the doctor did not specify what illness he has, and I am very concerned.
I would like to ask you what possible diseases he might have.
If I take my father to a large hospital for further examination, which department should we visit? Thank you!

Aji, 20~29 year old female. Ask Date: 2005/09/21

Dr. Liu Jinyong reply Family Medicine

Constipation; constipation is a common symptom often caused by changes in bowel habits.
Patients describe bowel movements as infrequent, incomplete, or characterized by excessively hard stools; they may also report needing to exert abnormal effort to complete a bowel movement.
A thorough understanding of the patient's habits can provide clues to the causes of constipation and ways to alleviate it.
It is recommended to increase dietary intake of fiber, drink more fluids, consume fruits and vegetables, and address a lack of exercise.
Proper adjustments to these factors can lead to significant improvement.
For further detailed examination, please consult a specialist in colorectal medicine (medical center).
Nasal polyps; nasal polyps are common growths found in the nose and sinuses that can be confused with tumors.
Nasal polyps may be asymptomatic or present with symptoms such as nasal discharge, nasal congestion, and loss of smell.
Direct examination of the nasal cavity can reveal polyps that differ from normal tissue; polyp tissue lacks nerve supply, making probe examination or palpation painless.
Treatment options include surgical removal or medication.
For further detailed examination, please consult an otolaryngologist (ENT specialist) at a medical center.
You mentioned that you have developed numerous red rashes below your lower back that have not resolved, and on the morning of September 20, you suddenly felt dizzy with a heart rate of 160 beats per minute.
Given your father's age (81 years) and the fact that heart disease is one of the top ten causes of death in this country, and since I have not examined or treated your father, I recommend that you take him to a medical center or a nearby public hospital for further detailed examination and treatment regarding the aforementioned conditions.
Please consult a dermatologist and a cardiologist.

Reply Date: 2005/09/21

More Info

Your father's situation is concerning, especially given his age and the combination of symptoms he is experiencing. The presence of urticaria (hives) along with episodes of rapid heartbeat (tachycardia) and low blood pressure can indicate several underlying issues that need to be evaluated further.

Firstly, the rapid heartbeat of 160 beats per minute, especially when accompanied by low blood pressure (70 mmHg systolic), could suggest a few potential problems. One possibility is that the rapid heartbeat is a response to stress or discomfort caused by the hives. Urticaria can sometimes lead to systemic reactions, including anaphylaxis, which can cause tachycardia and hypotension. However, since your father did not report any respiratory distress or severe allergic symptoms, this may be less likely.

Another consideration is that the rapid heartbeat could be a result of dehydration or an electrolyte imbalance, particularly if he has been experiencing constipation and dry mouth. Dehydration can lead to increased heart rate as the body attempts to maintain adequate blood flow and pressure. Additionally, certain medications used to treat hives or other conditions can also cause side effects such as increased heart rate.

Given your father's age and the complexity of his symptoms, it would be prudent to seek further evaluation. I recommend taking him to a hospital where he can be assessed by a cardiologist, as they specialize in heart-related issues. The cardiologist can perform a thorough evaluation, which may include an electrocardiogram (ECG), echocardiogram, and possibly a Holter monitor to assess his heart rhythm over a longer period.

In addition to cardiology, it may also be beneficial to consult with a dermatologist regarding the persistent hives, especially since they have not resolved with medication. The dermatologist can help determine if there is an underlying cause for the urticaria, such as an allergic reaction or another dermatological condition.

In summary, your father's symptoms warrant further investigation. The combination of hives, rapid heartbeat, and low blood pressure could indicate a range of issues, from allergic reactions to cardiovascular problems. Seeking care from both a cardiologist and a dermatologist will provide a comprehensive approach to diagnosing and managing his condition. It's essential to monitor his symptoms closely and seek immediate medical attention if he experiences any worsening of his condition, such as increased dizziness, chest pain, or difficulty breathing.

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