21 year old male with tachycardia

Nurses General Nursing

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Specializes in Progressive Care, Home Health.

Hello fellow nurses! I am stumped on this one. This isn't a hospital case. My brother is 21 years old, a healthy, happy, non-smoking college student with only one underlying health condition- Gilbert's Sydrome. Basically he just has chronic elevated liver enzymes, but nothing that's been a concern. He is physically fit, and works out 3+times a week. Lately, his resting heart rate has been in the 100's. Today, he was especially tachy at 120, resting. He does drink caffeinated products, but none in the last few days. I have experience in home care and a telemetry unit. Cardiology is one of my favorite systems to assess. I just can't figure it out....has anyone heard of something like this before? When he went to the ER, they did an EKG and found (what he told me) an elevated "P" wave. There were no apparent abnormalities in his rhythm. They also drew labs...I'm thinking a CBC, BMP, ...the works. They won't be doing any more tests that I know of. I have never seen a young, healthy person run tachy like that. If anyone has any advice or suggestions just let me know! I'd really appreciate it!!! :heartbeat

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

This is a friendly reminder that we are not supposed to bestow medical advice upon members due to the terms of service that have been established for these forums.

Personally, I was diagnosed with hyperthyroidism caused by Graves Disease at the age of 17. My resting pulse would be very elevated, so the doctor placed me on Lopressor to control the palpitations and tachycardia. I ended up having my thyroid ablated with radioiodine at the age of 24, and I am now hypothyroid.

I really hope that your brother's health issues can be resolved in some way. Please urge your brother to follow up with a PCP or cardiologist.

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Specializes in Triage RN, Cardiac, Ambulatory Care.

I would say F/U with a GP and cardiologist. Don't leave it hanging from what they said in the ER. This definitely needs follow up.

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Specializes in NICU Level III.

Around that age I had the same issue. Had an EKG, exercise stress test, labwork, and an echo and nothing. It went away on its own..

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Specializes in Management, Emergency, Psych, Med Surg.

He needs to have this worked up and not necessarily from a cardiac standpoint. His tachycardia sounds like a symptom of something else and I would be concerned about this increase in his liver enzymes. He needs to get to an endocrinologist or a GI doc.

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My daughter's 20, almost 21. She's been on lopressor and then cardizem for sinus tachycardia. The cardiologist didn't think it was serious (echo, halter-monitoring, all that was done) but is treating her because he said "it doesn't feel good to always feel like you just finished a marathon". Tell him to go to a good cardiologist, but not stress over it until he has a reason too! Happy Thanksgiving!

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Specializes in Progressive Care, Home Health.

Thanks guys! I'm not seeking medical advice, because I'm already pushing for an endocrinology consult. I was just completely puzzled because I've never heard something like this before. I'm thankful for your input. It's interesting to know there are other similar cases out there. I'm working on my BSN right now, and I'll be applying for the FNP program in the fall of next year. I'm really looking forward to learning more about sudden onset of symptoms and how they're related to other diseases/condtions. I'm always looking for new cases and trying to solve them (always playing detective!!)-

Thanks, I'll let you know the outcome!

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I know of two ladies with their resting HR around 100. They have been like this since their twenties , they are now in their forties. Both also have lower BPs 90/60

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hello,

I actually had all the same symptoms 8 yrs ago. Couldnt find anything wrong exactly. maybe IST? I was a healthy young person and no explanation and then it got worse and worse and I was hospitalized for 3 months looking for an answer. Now on beta blockers for IST.

Alot of people I know also have very high resting pulses. My daughter is 23 and hers can go to 130 just walking through the house (another ISTer).

Just a thought.

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Specializes in Cath Lab/ ICU.

Young people get tachcardic all the time. I mean, really. I see it frequently. It can happen for a variety of reasons, or no reason may be found.

My husband goes into PSVT frequently in the 160s. After many tests, echos, monitors...we found out that basically he just goes int PSVT!

Just follow up w/cardiology...

Btw, never heard of 'elevated' P waves, and they are hard to see with tachycardia(but not impossible in the 120s). However, I immediately though of peaked Ps, which makes me think of P Pulmonale, or right atrium enlargement. And of course, that's where the SA nodes is. But since you said that there is nothing wrong with the Rhythm, then I assume the 12 lead was ok. And 120 isn't really that fast, unless its sustained.

Let us know how it all works out!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Closing this thread as hopefully, OP's problems are resolved after over a year.

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