What is the effect of cocaine on heart rate?

Question

Hello doctor,

For the past two months, I have had a consistently elevated heart rate. It is not by much, but it is noticeable to me compared to what it used to be. I cut out alcohol and caffeine, and that helped, but the elevated heart rate always returns. My resting heart rate is consistently in the 53 to 58 bpm range. However, when I get up or go up or downstairs, it jumps to 100 pretty quickly, then averages out in the 80s as I move throughout the day. When I am sitting at work, it is usually between 78 and 85 bpm. This is a good 8 to 10 bpm faster than when I am at peak health. I am not sure what is going on.

A few months ago, I used to do a fair bit of cocaine and took some ED pills a few times (with the cocaine), so I am wondering if there might be a connection. I have not used any substances like that since then. I am a runner, but now when I run or jump, my heart rate goes up to 150 bpm and higher very quickly. If I push myself too hard, it climbs to 170 to 180 bpm easily, so I slow down. It also seems that my body is not recovering as quickly as it used to. As a result, I have stopped running hard and now just do light jogs and play tennis, where I recover more easily. But it is frustrating because I want to push myself while running.

I go two or three days without caffeine or alcohol, and during that time, I notice my walking-around heart rate is lower, around the mid-70s, like it used to be. When it is like that, I feel noticeably better. I feel more whole and energized, and I do not experience shortness of breath. But then, I will have a few glasses of wine that night, maybe some dessert (I like sugar at night), and when I lie down to sleep, my heart rate seems to jump to 85 to 95 bpm for a while. It can take two to three hours before it drops back down to 53 to 58 bpm, and the cycle starts again. I am really confused and do not know what is going on. Is it the alcohol or the sugar?

I usually drink one specific type of white wine, but I have noticed my heart rate does not react as much when I drink beer instead. One night, I had white wine and tequila, and my resting heart rate stayed around 68 to 78 bpm all night. I saw a doctor about three weeks ago, and they did an ECG and listened to my heart. Everything showed no issues or irregularities. I do not have chest pain, although I did experience a few sharp pains over the past two months—maybe two or three times, each lasting about one second, all while I was lying down in bed trying to fall asleep. I do get shortness of breath due to the elevated heart rate when I am carrying things, going upstairs, etc., but I do not have any pain in my chest, jaw, or left arm.

Sorry for the length, but I would really like to discuss this with someone who might have encountered something like this before. To clarify, what is annoying and confusing is that my heart rate will be steadily 8 to 10 bpm higher at all times (aside from resting rate) for seven to 10 days before it seems to go back to normal. But there is always something that sets it off again. I have never seen it spike over 105 bpm.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, but I assure you there is nothing to worry about. It is normal for the human heart rate to fluctuate. For example, during exercise, some people’s heart rate can rise to as high as 350 bpm, and that does not necessarily indicate a problem—it is just part of how the body responds. It is also normal for the heart rate to slow down when lying down. However, in some cases, like yours, the heart rate can increase while lying down, especially after drinking alcohol.

The issues you are experiencing with anxiety could likely be related to the cocaine you used in the past. I recommend that you resume exercising, starting with light jogging, it can really help with your situation. You only need to worry if you begin experiencing shortness of breath, chest pain, or fainting.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

The normal heart rate range is usually between 60 and 90 bpm. This is just a guideline because it can vary from person to person, depending on factors like body size and other individual differences. A person’s heart rate can change thousands of times a day due to various physiological factors such as eating, sitting, smoking, etc. This does not necessarily mean anything is wrong—it is simply how the body works. It is the same for everyone. It only becomes a concern if the heart rate is consistently 120 or 130 bpm at rest and is accompanied by symptoms.

The fact that you are frequently measuring your heart rate suggests that you may be feeling anxious, which may not be necessary. Why do you often feel the need to measure your heart rate? I do not think you have had a heart attack. A heart attack typically presents with symptoms like stabbing chest pain and shortness of breath. If you have had an ECG (electrocardiogram), it would show any issues.

Based on my experience with patients who have had similar concerns, I usually recommend exercise and engaging in social activities that can help distract from the worry. If this does not help, you may want to consider seeing a psychologist.

I hope this advice is helpful.

Thank you.