In the previous newsletter issue, my ECHO showed a resting heart rate of 91.
In this issue, let’s discuss how it all started.
I wake up every two to three hours. I don’t get quality sleep.
That's been my pattern since the April flu — the one that tripled my wake times and changed my sleep in ways that still haven't fully resolved. So when I woke up sometime around 2am on May 16, I wasn't alarmed.
I got up, used the bathroom, and got back into bed.
That's when I felt it. My heart started racing.
Not pounding dramatically. Not painful.
Just fast. A rhythm that didn't match the quiet of the night
Checked my watch: heart rate elevated. I reached for my blood pressure cuff. That was elevated too.
Sleep data from my watch, May 15-16. The gap between 2:30~4am is when I first went to the bathroom. The HR spike that followed is what kept me awake.
I lay there for about an hour and a half, watching the numbers, waiting for it to settle. It did — eventually. But not before I'd spent most of the night staring at the ceiling.
The next morning, my heart rate was still running higher than normal.
I've been tracking it long enough to know … this wasn't it.
So I drove myself to urgent care.
They found something. They didn't tell me what exactly. I just need to go to the ER instead. No details. No explanation. Just: go.
The ER diagnosed it as tachycardia. An abnormally fast heart rate. They ran their tests, nothing unusual, and sent me home.
No explanation of what caused it. Just followup with my primary care doctor.
Five years after a six-stent heart attack, my heart had done something that sent me from urgent care to the ER, and I left with a diagnosis that I’ve never had before.
Dr Marsh, my Primary care physician or PCP, listened to the full story: the waking up, the racing heart, the BP reading, the urgent care visit, the ER. And then she ordered a Holter monitor.
A Holter monitor is a portable cardiac recorder that captures your heart's electrical activity continuously — every beat, around the clock, for an extended period. Mine ran for seven days.
Seven days of wires stuck to my chest. Leads I had to check every morning to make sure they were still in place. Getting dressed required a choreography I hadn't anticipated. Showering was an exercise in careful maneuvering. Sleeping with the device took a few nights to get used to.
But I got used to it. Because the alternative — not knowing — was worse.
Then came the wait.
I wore the Holter monitor in June. The earliest a cardiologist could review the results with me was August 24.
More than three months.
In the meantime, my PCP looked at the preliminary data and told me she didn't think the results were particularly concerning — only one irregular event, and it hadn't lasted long. My heart rate was still elevated, but nothing she felt required immediate action.
She ordered a sleep study. Suspected the elevated heart rate might be connected to sleep apnea — a condition that triggers repeated autonomic surges throughout the night, keeping the heart running faster than it should.
Almost 5 months, and I'm still waiting for that sleep study as of this writing.
Finally, I sat down with a cardiologist to review the Holter results.
He was a little bit more concerned than my PCP had been.
He saw the arrhythmia. He saw the elevated heart rate pattern across seven days. He recommended an echocardiogram to assess my heart structure, plus a new medication: Coreg (a beta blocker) to slow things down.
I pushed back.
Not because I don't trust him. But because I've spent five years learning to ask why before I add anything new to my protocol. And I had questions he didn't have answers to yet.
Was the elevated heart rate structural? Damage from the 2021 heart attack expressing itself five years later?
Was it the sleep disruption from the April flu that never resolved?
Was it something else entirely? Something that hadn't been identified yet?
Adding a beta blocker before answering those questions felt like mopping the floor while the pipe was still leaking.
So I said: not yet. Let me wait for the sleep study first.
He noted my decision. We agreed to wait for more test results before committing to another pill.
I drove home with the same heart rate I'd arrived with, and a medication I hadn't started.
What I didn't know yet, what I wouldn't figure out for another three weeks, was that there was a fourth variable nobody had considered.
Something that happened the very next day.
That's in the next Issue 4.
Dennis
Cardiac Survivor · Your Friend in Recovery
Spokane, Washington
P.S. If someone forwarded this to you and you'd like to receive it directly, you can subscribe here: newsletter.cardiacsurvivor.org.
P.P.S. New here? The glossary has plain-English definitions of every term in this letter — tachycardia, Holter monitor, Coreg, and more: newsletter.cardiacsurvivor.org/p/glossary