[37F] Experiencing persistent tachycardia and chest discomfort post-COVID

Patient Description

A 37-year-old female reports experiencing a fast heart rate and shortness of breath, particularly during physical activity, which began over two years ago following a COVID-19 infection. The patient notes that her heart rate increases even upon waking from sleep and persists daily, lasting until she rests for about 10 to 15 minutes. She describes a dull chest pain in the sternum area, rated as 2 out of 10 in severity, which subsides after relaxation. The patient consumes approximately six 12 oz cans of caffeinated beverages daily and smokes less than 10 cigarettes a day. She has not undergone any follow-up evaluations or tests since her COVID-19 infection and is not currently taking any medications. There are no known allergies or other chronic conditions reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Postural Orthostatic Tachycardia Syndrome (POTS): This condition can cause an increased heart rate when you stand up or become active. It is sometimes seen after viral infections, including COVID-19. Symptoms can include rapid heart rate, fatigue, and dizziness.

    • Treatment often involves lifestyle changes, such as increasing fluid and salt intake, wearing compression garments, and gradually increasing physical activity. Medications may also be prescribed by a healthcare provider.
  • Deconditioning: After an illness like COVID-19, some people experience a decrease in physical fitness, which can lead to a rapid heart rate and fatigue with activity.

    • Gradual reconditioning through a structured exercise program can help improve symptoms.
  • Anxiety or Stress: These can contribute to a fast heart rate and chest discomfort, especially if you are worried about your health.

    • Techniques such as mindfulness, relaxation exercises, and counseling can be beneficial.
  • Caffeine and Nicotine Effects: Both caffeine and nicotine are stimulants that can increase heart rate and contribute to feelings of anxiety or restlessness.

    • Reducing or eliminating these substances may help alleviate symptoms.

What you can do

  1. Consult a Healthcare Provider: It's important to discuss your symptoms with a healthcare provider who can perform a thorough evaluation and recommend appropriate tests or treatments.
  2. Lifestyle Modifications: Consider reducing your caffeine and nicotine intake, as these can contribute to your symptoms. Gradually decreasing consumption can help minimize withdrawal effects.
  3. Hydration and Nutrition: Ensure you are well-hydrated and maintain a balanced diet to support your overall health.
  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your heart rate, and note any triggers or patterns. This information can be valuable for your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening chest pain
  • Fainting or severe dizziness
  • New or worsening shortness of breath
  • Any other concerning symptoms

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

People Also Ask


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how is it related to COVID-19?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition characterized by an abnormal increase in heart rate when transitioning from lying down to standing up. It can occur after viral infections, including COVID-19, and may cause symptoms like rapid heart rate, fatigue, and dizziness. Treatment often involves lifestyle changes and sometimes medication.


How can caffeine and nicotine affect heart rate and overall health?

Caffeine and nicotine are stimulants that can increase heart rate and contribute to feelings of anxiety or restlessness. High consumption of these substances can exacerbate symptoms like a fast heart rate and shortness of breath. Reducing intake can help alleviate these effects.


What are some effective lifestyle changes to manage a fast heart rate and shortness of breath?

Effective lifestyle changes include reducing caffeine and nicotine intake, staying well-hydrated, maintaining a balanced diet, and gradually increasing physical activity. These changes can help manage symptoms and improve overall health.


When should I seek medical attention for symptoms like chest pain and shortness of breath?

Seek medical attention if you experience severe or worsening chest pain, fainting, severe dizziness, new or worsening shortness of breath, or any other concerning symptoms. These could indicate a more serious condition that requires prompt evaluation by a healthcare professional.


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