Hi jlink,
It sounds like you indeed have vascular ES though your heart rate issues could also be related to your vagus nerve being irritated by one or both styloids &/or calcified stylohyoid ligaments if you have them.
Have you looked at our doctors’ list to see if there’s anyone on it near you?
In case you haven’t, here’s the link to the list. There are two doctors from your state, but on the chance you’ve seen them & gotten no help, you may have to consider going out of state. The type of doctor you need to see is a skull based ENT, maxillofacial or neuro surgeon. These doctors are often cancer specialists who work in the area of the neck where the styloids are. If you’d like specific recommendations for doctors in states other than your own, please let me know & I’ll give you some names of reliable ES doctors who’ve done many ES surgeries.
https://forum.livingwitheagle.org/t/us-doctors-familiar-with-es-2019/4752