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Cardiac & Vascular Health
Question #22103
94 days ago
235

How to reduce Palpitations body aches - #22103

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 hbA1c 5.1 Random blood sugar 101 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, [Your bisma]

Palpitations
Stomach issue
Body aches
Numbness
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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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Given the detailed history you provided, it’s entirely possible that your symptoms could be attributed to a combination of factors. The heart palpitations and tachycardia, especially along with the normal structural findings, make conditions like Inappropriate Sinus Tachycardia (IST) or Postural Orthostatic Tachycardia Syndrome (POTS) worth considering, especially given the persistent higher heart rates. Both of these conditions can sometimes follow viral illnesses and might explain the range of symptoms including palpitations, body aches, and possibly even the sensations of difficulty breathing. Additionally, post-viral syndrome could be playing a role, considering your dengue fever a few months back, which is known to have lingering effects for some individuals. Autonomic dysfunction can present with inclusively diverse symptoms like those you’ve described, including tingling, cold extremities and the sensation of throat tightness. Anxiety can definitely exacerbate these types of symptoms, though it might not be the primary cause.

In terms of further evaluations, a tilt table test or a 24-hour Holter monitor might provide more insight into your heart rate patterns and potentially confirm a diagnosis like POTS. It’s also notable that your Vitamin B12 levels are on the lower side; addressing this through diet or supplementation could help with some neurological symptoms like tingling and numbness. Given the raised CRP and ESR levels, it might suggest some continuing inflammatory process, although they are still relatively nonspecific. Lifestyle measures can also help manage symptoms: staying well hydrated, increasing salt intake (unless contraindicated), wearing compression stockings, and implementing regular gentle exercise can sometimes alleviate symptoms of orthostatic intolerance. Ensuring adequate rest, managing stress through mindfulness or other stress-reduction techniques can support overall well-being. Considering medication options like beta-blockers sometimes assist with controlling tachycardia if it’s significantly impacting life, but this would require further discussion with your cardiologist. If symptoms don’t improve or worsen significantly, you might want to see a specialist with a focus on autonomic disorders for additional management strategies.

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