Q:
My daughter is 28 and told she is in excellent health but recently has had episodes of very rapid heart beat over 100. F or about 6 weeks her heart is pounding so hard she is unable to sleep. Her blood pressure is low not high , she claims her left arm aches and her fingers feel tinglely.EKG normal , blood work normal except for elevated TSH . Normal chest xray, normal thyroid scan.
A:
Tachycardias (heart rates faster than 100 bpm) not associated with exercise and stress are abnormal and need to be examined. In general an elevated TSH suggests diminished thyroid function, whereas your daughter’s tachycardia suggests the opposite.
In short, more testing is indicated, that include more blood tests, an EKG, Holter monitor test, and maybe a cardiac ECHO depending on how the other tests come out.
The thyroid gland produces thyroid hormone. When it functions properly, the thyroid is part of a feedback loop with your pituitary gland. First, the pituitary senses the level of thyroid hormone that the thyroid has released into the bloodstream. The pituitary then releases a special messenger hormone, known as “Thyroid Stimulating Hormone” (abbreviated as TSH). TSH stimulates the thyroid to release more thyroid hormone.
When the thyroid, for whatever reason — illness, stress, surgery, obstruction, for example — does not produce enough thyroid hormone, the pituitary detects this reduction in thyroid hormone, and it moves into action. The pituitary then makes MORE TSH, to help trigger the thyroid to produce more thyroid hormone. This is the pituitary’s effort to return the system to “normal” and normalize thyroid function.
There, a TSH that is higher than normal suggests a thyroid that is underactive and not doing its job of producing thyroid hormone. So, in general:
HIGHER TSH = UNDERACTIVE THYROID / HYPOTHYROIDISM.
Please check these links for more information about palpitations:
- http://www.cardiac-risk-assessment.com/ca-blog/palpitations/
- http://www.cardiac-risk-assessment.com/ca-blog/palpitations-and-pvcs/
- http://www.cardiac-risk-assessment.com/ca-blog/i-am-worried-about-v-tach-ventricular-tachycardia/
- http://www.cardiac-risk-assessment.com/ca-blog/what-are-some-of-the-causes-of-premature-ventricular-contractions-pvcs/
- http://www.cardiac-risk-assessment.com/ca-blog/palpitations-and-fainting/
You’ll find these are rather common complaints and most people don’t need treatment, only reassurance once their heart proves OK. In your daughter’s case, she needs more testing, both of her Thyroid gland and her heart rhythm.
Read these, get those tests done and come back if you still have questions for me,
Hope this helps,
Dr T