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Pulse rate high reason?
Hello Senior Doctor,
I have been experiencing persistent anxiety, excessive sweating, palpitations, and a resting pulse rate frequently above 100 bpm. My investigations show normal thyroid function (TSH 1.75 mIU/L, T3 and T4 within normal limits), normal hemoglobin (13.4 g/dL), and normal kidney function, thereby ruling out thyroid disorder, anemia, and chronic kidney disease as major causes.
However, the following abnormalities were detected:
• SGPT (ALT): 83.9 U/L (elevated)
• GGT: 91.6 U/L (elevated)
• Total Cholesterol: 206 mg/dL (elevated)
• LDL Cholesterol: 139 mg/dL (elevated)
• HDL Cholesterol: 34.9 mg/dL (low)
• Triglycerides: 160 mg/dL (borderline elevated)
• Fasting Blood Sugar: 101.5 mg/dL (borderline elevated)
• MCHC: Low
• RDW and RDW-SD: Elevated
Despite these investigations, the cause of my persistent tachycardia remains not clear. Advocate profession. No alcohol or smoking
Answers (17)
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Your symptoms of persistent tachycardia above 100 bpm, palpitations, excessive sweating, and anxiety â with thyroid confirmed normal â need further workup. The elevated SGPT (83.9) and GGT (91.6), combined with very low HDL (34.9), borderline triglycerides, borderline blood sugar, and the LDL/cholesterol pattern, form a picture consistent with metabolic syndrome and likely non-alcoholic fatty liver disease (NAFLD). The low MCHC and elevated RDW need iron studies and a peripheral smear. Most importantly, the triad of unexplained persistent tachycardia, profuse sweating, and anxiety must prompt ruling out phaeochromocytoma (an adrenal tumor) â this is a classic presentation for it and must not be missed even though it is rare.
Next Steps
Please see an internal medicine physician urgently with all your reports. Key additional tests needed: iron studies and peripheral smear (for MCHC/RDW), plasma or 24-hour urine metanephrines (to rule out phaeochromocytoma), and a 24-hour Holter monitor to characterize the tachycardia. Please consult me directly on Practo for a detailed evaluation.
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Your thyroid, hemoglobin, and kidney tests are normal, which is reassuring. The ECG image is not very clear, but persistent resting pulse >100/min with palpitations and sweating needs further evaluation. Anxiety can contribute, but other causes should be excluded. I would advise a 24-hour Holter monitoring, 2D Echo, blood pressure assessment, serum electrolytes (especially magnesium and potassium), and consultation with a cardiologist. Avoid excess caffeine, energy drinks, and stress triggers. If you develop chest pain, breathlessness, dizziness, or fainting, seek urgent medical attention. Your elevated liver enzymes and abnormal lipid profile also need follow-up and lifestyle modification.
Next Steps
Consult a cardiologist for clinical evaluation. Get a 24-hour Holter monitoring, 2D Echo, blood pressure assessment, and serum electrolytes (potassium and magnesium). Also repeat liver function tests and lipid profile after medical review.
Health Tips
Avoid caffeine, energy drinks, smoking, alcohol, and unnecessary stress. Ensure adequate sleep, hydration, and regular physical activity as tolerated. If you develop chest pain, shortness of breath, dizziness, fainting, or a very rapid heartbeat, seek immediate medical attention.
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