What is the cause of my tachycardia, with resting heart rate of 85 beats per minute (bpm) and episodes of tachycardia up to 150 bpm during brief physical activity, in the context of a sedentary lifestyle, weight gain of 45 pounds, sleep apnea, and average blood pressure of 115/76 millimeters of mercury (mmHg), four years after contracting Coronavirus disease 2019 (COVID-19)?

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Last updated: March 9, 2025View editorial policy

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From the Guidelines

You should consult with a healthcare provider about your elevated heart rate, which may be related to multiple factors including post-COVID effects, weight gain, sedentary lifestyle, and sleep apnea. While your blood pressure is normal, your resting pulse of 85 bpm and episodes reaching 100-150 bpm warrant medical evaluation 1. In the meantime, gradually increase physical activity by starting with 10-15 minute daily walks and slowly building up to 150 minutes of moderate exercise weekly. Focus on weight management through portion control and a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Ensure you're using your CPAP machine consistently for sleep apnea. Limit caffeine, alcohol, and nicotine which can elevate heart rate. Stay hydrated and practice stress-reduction techniques like deep breathing or meditation.

Post-COVID tachycardia (elevated heart rate) is recognized in some patients, but your weight gain and sedentary lifestyle are likely contributing factors 1. At your age and weight, these lifestyle modifications could significantly improve your cardiovascular health, but professional medical assessment is essential to rule out other potential causes. The American College of Cardiology/American Heart Association task force on clinical data standards has identified post-acute COVID-19 syndrome as a potential cause of long-term cardiovascular complications, including tachycardia, and recommends monitoring and management of these complications 1.

Some possible mechanisms for your tachycardia include:

  • Direct and indirect viral-mediated cellular damage
  • Procoagulant state
  • Immunologic response affecting the structural integrity of the myocardium, pericardium, and conduction system
  • Downregulation of angiotensin-converting enzyme-2 (ACE2) 1 It is essential to consult with a healthcare provider to determine the underlying cause of your tachycardia and develop a personalized treatment plan.

From the Research

Potential Causes of Tachycardia

  • A sedentary lifestyle and weight gain of 45 pounds may contribute to increased heart rate and episodes of tachycardia 2, 3
  • Sleep apnea can lead to disruptions in normal sleep patterns, physical and mental health, and may exacerbate conditions such as tachycardia, especially in individuals with pre-existing conditions like obesity and hypertension 2, 4, 3, 5
  • The COVID-19 pandemic has had a significant impact on sleep services and diagnosis, which may have affected the management and treatment of sleep apnea, potentially contributing to the development of tachycardia 2, 3, 5, 6
  • The relationship between obstructive sleep apnea (OSA) and adverse COVID-19 outcomes, including increased risk of morbidity and mortality, may be relevant to the development of tachycardia in individuals with a history of COVID-19 4, 3

Association Between Sleep Apnea and Tachycardia

  • Studies have shown that OSA is related to higher mortality and morbidity in patients with COVID-19, and may independently increase the risk of morbidity and mortality associated with COVID-19 2, 4, 3
  • The severity of OSA has been linked to increased risk of adverse COVID-19 outcomes, including moderate COVID-19 severity, although the extent of this correlation is unclear 4
  • The management of OSA during the COVID-19 pandemic has been affected, with changes in sleep schedule, weight gain, and increased anxiety, which may contribute to the development of tachycardia 5

Impact of COVID-19 on Sleep and Tachycardia

  • The COVID-19 pandemic has had a major effect on the treatment, management, and diagnosis of OSA, and may have contributed to the development of tachycardia in individuals with a history of COVID-19 2, 3, 5, 6
  • The pandemic has led to increased anxiety, changes in sleep schedule, and weight gain in patients with OSA, which may influence mental health and contribute to the development of tachycardia 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Obstructive Sleep Apnea with COVID-19.

Advances in experimental medicine and biology, 2022

Research

Effects of COVID-19 on Sleep Services Use and Its Recovery.

Nature and science of sleep, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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