Hello dear See as per clinical history it seems post autonomic viral symptoms only. The reason behind is that the stimulation of autonomic nervous system even on doing mild physical work Iam suggesting some medication and precautions. Precautions you can follow for improvement but some medication have to be recommended by cardiologist only Change of posture Avoid long standing Do mild physical exercise Avoid over lifting start with smallest weight to increase endurance In addition you may be given Atenolol 25 mg Clonidine Midodrine Please get these medicines only after recommendation from cardiologist or concerned physician Please donot take any medication without consulting the concerned physician Hopefully you recover soon Regards
Hello Bisma, thank you for sharing your concern. Based on your reports, this appears to be post-viral autonomic dysfunction (IST/POTS-like) with a significant anxiety component.
For the sore throat: do not start antibiotics unless there is fever, pus on tonsils, or a positive throat test. Simple gargles, warm fluids, and paracetamol are enough for now.
Bisoprolol (Concor 2.5 mg) should not be started on your own. Kindly consult one to one with a Physician for this.
You should start Vitamin B12 supplementation. Start Tab. Methylcobalamin 1500mcg at night × 2 months.
What to do now: Good hydration. Gentle daily walking, avoid bed rest. Anxiety management (breathing exercises). Repeat CRP & ESR after 2–3 weeks.
Seek urgent care if you develop chest pain, fainting, breathlessness, or HR persistently >150 at rest.
Regards, Dr. Nirav Jain MBBS, D.Fam.Medicine
Based on your history, test results, and symptoms, there is no evidence of a serious heart disease. Multiple ECGs show only sinus tachycardia, and your echocardiogram is normal, which is very reassuring.
What is most likely going on
Your symptoms are most consistent with a post-viral autonomic disturbance (after dengue), possibly combined with anxiety and nervous system hypersensitivity. This can cause:
Fast heart rate and palpitations
Whole-body pulsations
Cold hands and feet
Tingling, numbness, body aches
Throat tightness / lump sensation (called globus sensation)
Hello Bisma Thank you for sharing all these details—your symptoms and the tests you’ve had help paint a clear picture. Here’s a summary and what it means for you:
What’s Going On? - Heart palpitations and high heart rate: Your ECGs show sinus tachycardia (a fast but regular heart rhythm from the heart’s natural pacemaker), and your echo is normal. This means your heart structure is healthy. - Body aches, tingling, cold hands/feet, numbness, lump in throat, and breathing sensations: These symptoms are common in conditions like post-viral syndromes (especially after dengue), anxiety, or sometimes autonomic nervous system imbalance (like inappropriate sinus tachycardia or POTS). - Oxygen levels are normal: This is reassuring and means your lungs and heart are working well.
What Else Should Be Checked? Since your heart structure is normal and you’ve had dengue recently, the following tests can help rule out other causes: - Electrolytes (sodium, potassium, calcium, magnesium): Imbalances can affect heart rhythm and nerves. - Blood sugar (fasting and postprandial): To rule out diabetes or hypoglycemia. - ESR/CRP: To check for ongoing inflammation. - Holter monitoring (24–48 hours): If not already done, this can track your heart rhythm over a longer period.
Inappropriate sinus tachycardia (IST) is a condition where the heart rate is elevated without an obvious cause. To confirm this diagnosis and rule out other potential issues, several tests may be recommended: 1. Electrocardiogram (ECG): This test records the electrical activity of your heart and can help identify abnormal heart rhythms. 2. Holter Monitor: A portable ECG device worn for 24-48 hours to monitor your heart rate and rhythm during daily activities. 3. Echocardiogram: An ultrasound of the heart to assess its structure and function, ruling out any underlying heart conditions. 4. Exercise Stress Test: This test evaluates how your heart responds to physical stress and can help identify any exercise-induced arrhythmias. 5. Blood Tests: These may include thyroid function tests, electrolyte levels, and other markers to rule out metabolic or hormonal causes of tachycardia. 6. Tilt Table Test: This test assesses how your heart rate and blood pressure respond to changes in position, which can help identify autonomic dysfunction. 7. Electrophysiological Study (EPS): In some cases, a more invasive test may be performed to study the electrical pathways of the heart.
What Does This Mean? - Most likely, your symptoms are due to a combination of post-viral effects (common after dengue), possible anxiety, and maybe mild autonomic dysfunction. - The fact that your heart structure is normal is very reassuring. - These symptoms often improve with time, hydration, gentle exercise, and stress management.
What Should You Do Next? - Discuss the above tests with your doctor if not already done. - Focus on hydration, regular meals, gentle physical activity, and good sleep. - If symptoms worsen (fainting, chest pain, severe breathlessness), seek medical help immediately.
For sore throat - Rx- tab Amoxicillin 625 mg- once a day after food Tab Tusq dxdt - twice a day after food Gargle with hot water and salt Drink glucose as it can be because of hypoglycemia too .
Thank you and get well soon
To address your concerns, let’s break down the possibilities and steps forward. Given your history of a recent dengue infection and current symptoms, post-viral syndrome might be a potential cause. Such conditions can lead to autonomic dysfunction, possibly presenting as symptoms similar to POTS (Postural Orthostatic Tachycardia Syndrome). Your heart rate readings point to sinus tachycardia, which might explain some of your symptoms. It is reassuring that your echocardiography is normal, reducing concerns about structural heart issues. Your Vitamin B12 level is on the low side, and while it’s not critically deficient, it might be worth addressing, as low B12 can contribute to fatigue, tingling, and other neurological complaints. Discuss with your doctor about starting vitamin B12 supplementation, as it seems safe given your levels but your physician should confirm its appropriateness based on your overall health picture. Regarding Bisoprolol (Concor), this beta-blocker could help control your heart rate and manage symptoms like palpitations, but its use should be closely evaluated by your doctor, especially considering your age and recent medical history. It’s not something to start without medical supervision due to potential side effects, including effects on blood pressure. For your sore throat, antibiotics should only be taken if there’s evidence of a bacterial infection, which is not clear from your description. Consider seeing a doctor if symptoms persist, to rule out a strep throat or other bacterial causes. Your inflammatory markers (CRP and ESR) are slightly elevated, which could point to ongoing inflammation consistent with post-viral recovery or another underlying cause. Additional testing could be considered, like tests for adrenal function or tilt-table testing for POTS, but these would require consultation with a specialist. As for lifestyle, consider measures like adequate hydration, balanced diet, and possibly wearing compression stockings if you experience symptoms on standing—these can assist with blood flow and reduce palpitations linked to POTS-like symptoms. Gentle physical activity can help autonomic regulation, but start gradually to avoid symptom exacerbation. Stress management techniques, like mindfulness or relaxation exercises, might aid if anxiety is contributing. Lastly, keep a symptom diary for your physician to help identify patterns or triggers. Remember, any decision about medication or further tests should be made in collaboration with your healthcare provider.
Doctor my bp is always ranges between 120 to 140 systolic and 80 to 90 diastolic Mostly 128 by 81 but hr always stays around 90 to 110 I took concor yesterday but it’s effect last for 8 hours on hr then hr becomes 104 and bp is 117 75
Here every doc suggest beta blockers I have sinusitis and sore throat they are not suggesting any test and don’t take my condition seriously they said this anxiety or ist(inappopirate sinus tachycardia) I have also body aches that come and go not constant but body aches are so bad 😔 now I recently check my bp 128 84 or hr is 91
They said to take concor 2.5 mg for 1 month then he said he slowly taper off I am just worry that it cause any change or it mask if. there is other underlying cause
I got evaluated by 4 physicians and 2 cardiologists
Actually the pots and ist are very uncommon and not known here so I don’t know what so I have anxiety for not proper diagnosis I always listen to any disease and my brain start thinking it might be mine
Your symptoms fit best with post-viral autonomic dysfunction after dengue, worsened by low vitamin B12, not heart disease—your ECGs and echo showing only sinus tachycardia support this. Do not start antibiotics or bisoprolol on your own; treat the sore throat conservatively for now and start vitamin B12 supplementation, along with good hydration and electrolyte intake. Specialist consultation: follow up with a cardiologist/physician (and consider neurology if tingling persists) to guide medication only if symptoms continue or worsen.
