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Cardiac & Vascular Health
Question #22100
94 days ago
232

How to reduce heart palpitations and pain in body - #22100

Bisma

Hello Doctor, I am an 18-year-old female seeking guidance regarding ongoing symptoms for the past 2 months. My main concern is heart palpitations and high heart rate. I have recorded a maximum HR of 150 bpm on ECG, around 110 bpm during doctor visits, and 90–100 bpm at rest normally. I have undergone 4 ECGs, all showing sinus tachycardia. I have been evaluated by two cardiologists. My echocardiography is normal, and no structural heart disease was found. Along with this, I experience full body aches, mainly in the neck, shoulders, arms, calves, and sometimes joint discomfort. I also have tingling sensations, cold hands and feet, and occasional numbness, especially with sitting or activity. Sometimes I feel a lump/tightness in the throat, with a sensation of difficulty breathing, though oxygen levels are normal. Relevant history: Had dengue fever 3 months ago These symptoms started about 2 months ago and persist Investigations done: Echocardiography: Normal Abdomen & pelvis ultrasound: Normal TSH: 1.28 CBC: WBC 11,000; Hb 13.1; RBC 5.1; Platelets 371,000 CRP: 11 ESR: 42 Vitamin D: 36 Ferritin: 46 Vitamin B12: 198 Cholesterol: 166 Evening cortisol: 10 I would like your opinion on: Whether these symptoms could be due to circulation issues, autonomic dysfunction (e.g., IST/POTS-like), post-viral effects, or anxiety-related causes Whether any further tests are needed Whether treatment or lifestyle measures should be started at this stage Thank you for your time and guidance. Kind regards, [Bisma]

Age: 18
#palppersistent palpitations #tachycardia #body aches #guidance needed
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Doctors' responses

Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
94 days ago
5

Hello

Based on your reports, this is NOT heart disease.

Your symptoms fit best with post-viral autonomic dysfunction (IST / POTS-like) after dengue, with anxiety amplification

What helps right now

Lifestyle Increase fluids (2.5–3 L/day) Increase salt intake (unless doctor said no) Small frequent meals Avoid caffeine, energy drinks Gentle walking + stretching daily (don’t over-rest) Good sleep routine

Supplements Vitamin B12 supplementation (oral or injections as advised) Magnesium can help palpitations & muscle pain

For palpitations/anxiety loop Slow breathing (4–6 breaths/min) Reassurance reduces HR significantly in IST

Do you need more tests?

Only if symptoms worsen: Orthostatic vitals / Tilt table test (to confirm POTS if suspected) Repeat CRP/ESR after a few weeks Otherwise no urgent tests needed

This condition is reversible Many young patients improve over 3–6 months You are not in danger

I trust this helps Take care Thank you

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
94 days ago
5

Hello dear See as per clinical history it seems combination of both heart related impact and post viral impact. Since there is already presence of sinus tachycardia so definitely medication are required to control it. Bp is fine but joint pain and lethargy/ weakness could be attributed to post dengue effects probably due to recovery. Iam suggesting some tests for confirmation Please share the result with cardiologist in person for better clarity Also take medication only on confirmation of exact diagnosis by concerned physician Serum troponin Serum LDH ECG echo repeat X ray chest Esr repeat CBC repeat Crp Cck Mb Lft Rft Serum ferritin Regards

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Based on the symptoms you’re experiencing—heart palpitations, a high resting heart rate, body aches, and neurological symptoms—it seems reasonable to consider several potential causes. The prior history of dengue fever might suggest a post-viral syndrome could be contributing to these ongoing issues. Such syndromes sometimes involve autonomic dysregulation, which might lead to your symptoms like sinus tachycardia, palpitations, and tingling sensations. However, given your age and the normal echocardiogram, structural heart conditions seem unlikely.

The elevated inflammatory markers (CRP and ESR) indicate some ongoing inflammation, which can sometimes be related to post-viral states or other conditions. Low-normal levels of vitamin B12 might also account for some neurological symptoms, such as tingling and numbness. Supplementation with vitamin B12, either through dietary sources like meat, fish, dairy, or supplements, might be beneficial. Deferring to your physician about initiating B12 injections might also be worthwhile for faster restoration if there’s significant deficiency.

As for lifestyle measures, adequate hydration, balanced nutrition, regular light physical activity, and stress management techniques such as meditation or breathing exercises can support autonomic function and overall health. Gradual reconditioning exercise—like swimming or cycling—can also be helpful for potential autonomic dysfunction like POTS. Given your symptoms and test results, further evaluation with a tilt table test or continuous heart rate monitoring could provide more insight into whether autonomic dysfunction plays a significant role.

It’s also vital to address anxiety if it’s a contributing factor. Cognitive-behavioral therapy (CBT) or discussions with a psychologist or psychiatrist might be strategies worth considering. Most importantly, if these symptoms escalates or new alarming symptoms arise like chest pain or significant shortness of breath, further immediate medical evaluation would be essential to rule out any serious conditions. Check with your doctors to tailor these strategies to your needs, and ensure regular follow-ups to monitor your condition’s progression.

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