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Racing Heartbeat: Should You See a Doctor?

My heart was beating really fast, but I don’t have symptoms now. Should I see a doctor?

If you’ve asked yourself this question, then you’ve probably noticed your heart skipping a beat, fluttering, or just feeling like it’s working too hard inside your chest, neck, or throat.

Everyone has a racing heart from time to time. Stress, exercise, or even too much alcohol or caffeine can cause your heart to beat faster than normal.

But if your heart races a lot—or if you notice your heartbeat is often irregular—then you should see a doctor.

Even though most racing heartbeats are caused by common situations (like stress or fevers), some irregular heartbeats are caused by serious heart conditions like atrial fibrillation. People who have these conditions need monitoring and treatment from a cardiologist (heart doctor).

What Causes a Racing Heart?

Normal hearts beat 60—100 times every minute. When your heart beats more than 100 times each minute, that’s considered high (called tachycardia in the medical world). Fast heartbeats can last for seconds to hours.

Not all cases of a racing heartbeat are dangerous. Many everyday situations that aren’t related to heart problems can cause your heart to race. These can include the following:

• heavy exercise
• stress, fear, anxiety, or panic attacks
• low blood sugar or low blood pressure
• fevers, anemia, and dehydration
• pregnancy or menstruation
• too much alcohol, caffeine, or nicotine
• illegal drugs like ecstasy, methamphetamines, or cocaine

If you notice that your heart is beating faster than normal, look for obvious explanations first:

• Are you stressed out?
• Have you had more caffeine than usual?
• Is your blood sugar low?

You can also try keeping a diary of your symptoms and write down what you were doing before you started to notice your heart was beating fast. Recording when your heart rate goes up can help your doctor better pinpoint what’s causing it.

If you notice that your heart is racing a lot and you’re not exercising or stressed (for example), then you should think strongly about seeing a doctor.

Heart Diseases That Can Cause a Racing Heart

Sometimes a fast or irregular heartbeat can be a sign of a serious heart condition. These conditions include the following:

• heart failure
• a past heart attack
• coronary artery disease (CAD)
• problems with your heart’s valves or muscles
• atrial fibrillation

If your doctor thinks you may have one of these conditions, your doctor may give you an EKG, a chest X-ray, or an echocardiogram (echo test) to diagnose what’s wrong.

Atrial Fibrillation

Atrial fibrillation is one of several heart conditions that can cause an irregular heartbeat. Also known as A-Fib or AF, atrial fibrillation causes your heart’s upper chambers (atria) to beat faster than normal. People with A-Fib have electrical signaling problems in the upper part of their heart.

Atrial Fibrillation & Strokes

Atrial fibrillation is a serious condition that can be life-threatening. As many as six million people in the US may have atrial fibrillation. But one in three people who have A-Fib don’t know they have it.

A-Fib may also increase your chances of having a stroke.

That’s because A-Fib’s irregular heartbeat lets blood pool inside the upper chambers of your heart. This pooled blood can cause blood clots, which can then travel out of your heart and into your brain, which causes a stroke.

If you think you may have A-Fib, it’s important to make an appointment with a cardiologist.

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Arrhythmia

Arrhythmias also cause fast or irregular heartbeats, or can make your heart beat too slowly. Arrhythmias happen when the electrical signals inside your heart don’t happen when and how they should.

Atrial fibrillation is one type of arrhythmia.

When to Call a Doctor Right Away

Call your doctor or 911 right away if you have a fast or irregular heartbeat and you also have:

• chest pain
• fainting
• dizziness
• shortness of breath

These symptoms may be signs of a heart attack or stroke.

Next Steps

Many times, fast or irregular heartbeats are caused by normal life situations, like drinking too much caffeine or having anxiety.

But if you notice that your heart is beating quickly a lot, you should consider seeing a cardiologist to make sure you don’t have a dangerous, undiagnosed heart condition.

Call us at 801-585-7676.

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Heart palpitations: MedlinePlus Medical Encyclopedia

Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.

You may:

• Have an unpleasant awareness of your own heartbeat
• Feel like your heart skipped or stopped beats

The heart’s rhythm may be normal or abnormal when you have palpitations.

Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise routinely or take medicines that slow the heart.

If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.

Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.

The following conditions make you more likely to have an abnormal heart rhythm:

• Known heart disease at the time the palpitations begin
• Significant risk factors for heart disease
• An abnormal heart valve
• An electrolyte abnormality in your blood — for example, a low potassium level

Heart palpitations can be due to:

• Anxiety, stress, panic attack, or fear
• Caffeine intake
• Cocaine, methamphetamine or other stimulant drugs
• Decongestant medications, such as phenylephrine or pseudoephedrine
• Diet pills
• Exercise
• Fever
• Nicotine intake

However, some palpitations are due to an abnormal heart rhythm, which may be caused by:

• Heart disease
• Abnormal heart valve, such as mitral valve prolapse
• Abnormal blood level of potassium
• Certain medicines, including those used to treat asthma, high blood pressure, or heart problems
• Overactive thyroid
• Low level of oxygen in your blood

Things you can do to limit palpitations include:

• Lower your intake of caffeine and nicotine. This will often reduce heart palpitations.
• Learn to reduce stress and anxiety. This can help prevent palpitations and help you better manage them when they occur.
• Try deep relaxation or breathing exercises.
• Practice yoga, meditation, or tai chi.
• Get regular exercise.
• Do not smoke.

Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.

If you have never had heart palpitations before, see your provider.

Call 911 or the local emergency number if you have:

• Loss of alertness (consciousness)
• Chest pain
• Shortness of breath
• Unusual sweating
• Dizziness or lightheadedness

Call your provider right away if:

• You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
• You have heart disease or risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
• You have new or different heart palpitations.
• Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
• You have related symptoms, such as chest pain, shortness of breath, feeling faint, or loss of consciousness.

Your provider will examine you and ask questions about your medical history and symptoms.

You may be asked:

• Do you feel skipped or stopped beats?
• Does your heart rate feel slow or fast when you have the palpitations?
• Do you feel a racing, pounding, or fluttering?
• Is there a regular or irregular pattern to the unusual heartbeat sensations?
• Did the palpitations begin or end suddenly?
• When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
• Do you have any other symptoms?

An electrocardiogram may be done.

If you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.

If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:

• Holter monitor for 24 hours, or another heart monitor for 2 weeks or longer
• Echocardiogram
• Electrophysiology study (EPS)
• Coronary angiography

Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing

• Heart chambers
• Heart beat
• Yoga

Fang JC, O’Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 10.

Miller JM, Tomaselli GF, Zipes DP. Diagnosis of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli, GF, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 35.

Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Valeriya Tonkoshkurova: Heart palpitations at night are not normal

At night, our body is controlled by the vagus nerve — it slows down the pulse, lowers blood pressure, and slows down all physiological processes. But if in silence you hear that your heart is beating too fast, this is an alarming sign. About what is happening, we were told by a cardiologist, Ph. D. Valeria Tonkoshkurova.

– Valeria, some complain that they wake up at night with a strong heartbeat. Does this indicate some kind of disease or can you sleep peacefully?

– Tachycardia, it’s also a rapid heartbeat – this, of course, is not the norm. The standard heart rate is 60-90 beats per minute. When the number of beats is higher, you will feel like your heart is jumping out of your chest. Artistically speaking, our “fiery engine” is a bird that beats in the chest. Of course, if the bird is sick. A healthy one sits quietly and does not “chirp” in vain. Therefore, rapid heartbeat, and especially at night, is an uncharacteristic phenomenon.

— What can cause nocturnal tachycardia?

– There are many diseases that are directly related to heart rhythm disturbances – from hypertension at night and atrial fibrillation to terrible ventricular tachycardias that threaten to stop the heart. The pulse is very frequent, in some diseases uneven, intermittent. Attacks are accompanied by shortness of breath, sweating, weakness, fear of death, there may be dizziness and loss of consciousness. Therefore, a complete examination of the cardiovascular system is required.

Violent palpitation possible during nocturnal panic attacks. They often occur with stress, post-traumatic nervous disorder, chronic fatigue syndrome and other problems of the nervous system. In this case, I advise you to visit a psychotherapist and a neurologist, take a course of cognitive behavioral therapy, psychotherapy and taking sedatives.

— Are there any non-obvious reasons that can lead to nocturnal palpitations?

— For example, potassium deficiency in the body, including while taking medications such as insulin, diuretics, penicillins. It is an essential trace element for the nervous and cardiovascular systems. A decrease in its level to values ​​​​less than 3.5 mmol / l already threatens with serious consequences, it will be manifested by heart rhythm disturbances, heart palpitations, leg muscle spasms. Include potassium-rich foods in your diet – dried apricots, raisins, bananas, spinach, avocados.

— Is it true that sleep apnea is also the cause of a strong nighttime heartbeat?

– Apnea is a short pause in breathing during sleep. During these intervals, a person wakes up in a cold sweat, with a strong heartbeat, a feeling of fear of death, and suffocation. There can be many such attacks during the night, and as a result, several hours of oxygen starvation come up in the morning with all the ensuing consequences: from simply feeling unwell, daytime lethargy and fatigue to serious diseases.

If sleep apnea is suspected, such as loud snoring and shortness of breath during sleep, then a sleep specialist, neurologist or ENT doctor should be consulted to determine the cause. There are such diagnostic methods as polysomnography (sleep study using computers), daily computer pulse oximetry (blood oxygen saturation). It is advisable to lose weight, quit smoking, because smoking causes chronic inflammation and swelling of the throat. It is necessary to check the thyroid hormones – their deficiency also causes swelling and a decrease in muscle tone of the whole body.

— What to do with nocturnal tachycardia?

– First of all, consult a cardiologist to rule out heart disease. The doctor will prescribe 24-hour Holter ECG monitoring to detect heart rhythm disturbances, confirm or refute the tachycardia itself, determine its type, suggest hypokalemia and exclude ischemic changes that also provoke palpitations. Coronary artery disease in some cases may be manifested only by heart rhythm disturbances, and not by pain. It would be good to do an echocardiogram to exclude disturbances in the structure of the heart, since valvular defects are also accompanied by rhythm disturbances. It is necessary to look at a detailed biochemical blood test, the level of electrolytes (potassium, calcium, magnesium, chlorine, sodium), thyroid hormones – TSH, T3, T4. From simple recommendations – do not overeat at night, do not stimulate the nervous and cardiovascular system in the evenings with smoking, alcohol and strong physical exertion. It is also important to get enough sleep and eat properly, fully and balanced.

Cardiac arrhythmia – symptoms, causes and treatment at the Vascular Innovation Center in Moscow

Heart rhythm disturbances (arrhythmias) are a condition in which the heart beats irregularly, too fast, or too slowly. With frequent contractions of the heart – above 100 beats per minute in adults, this condition is called tachycardia, with rare – less than 60 beats per minute is called bradycardia. Some types of arrhythmia do not have symptoms. If the arrhythmia is symptomatic, then the main complaints are palpitations or a feeling of a pause between heartbeats. Occasionally, patients may complain of dizziness, fainting, shortness of breath, or chest pain. Most types of arrhythmia are not a serious threat to the patient, however, complications such as stroke or heart failure can often occur, and sometimes an arrhythmia can lead to cardiac arrest.

The Innovative Vascular Center employs experienced cardiologists who can help you determine exactly why cardiac arrhythmia occurs and prescribe the right treatment. In addition to drug therapy, artificial pacemakers (pacemakers) of any configuration are implanted in our clinic. Timely and correct treatment allows our patients to avoid many complications, which means prolonging life and improving its quality.

Signs of cardiac arrhythmias

There are four main types of arrhythmias: extra beats (extrasystoles), idiopathic supraventricular tachycardia, ventricular arrhythmias, and bradyarrhythmias (slowing of the rhythm). Additional beats include premature atrial contractions and ventricular premature beats.

Slow heartbeat – bradycardia

Bradycardia is a condition where the heart beats so slowly that it cannot pump enough blood to meet the body’s needs. If left untreated, bradycardia can lead to extreme fatigue, dizziness, or fainting because not enough blood is getting to the brain. This condition can be corrected with an electronic pacemaker, which makes the heart beat normally.

Bradycardia occurs for various reasons:

• Sick sinus syndrome

The occurrence of sinus bradycardia as a result of a “malfunction” in the sinus node (the heart’s natural pacemaker), occurs when shocks for contractions occur too rarely. Weakness of the sinus node can develop with age or be the result of an illness. Some medications can also cause or worsen bradycardia. This arrhythmia may be temporary or permanent. It can be treated with medication or with an electronic pacemaker.

• Heart block

Heart block is a slowing or interruption of the electrical signal to the lower chambers of the heart (ventricles) that causes the heart muscle to contract. The electrical conduction system of the heart normally sends signals from the upper chambers of the heart (the atria) to the lower chambers (the ventricles), which causes coordinated contractions of the heart muscle. Complete blockade of the atrioventricular node may be manifested by a sudden loss of consciousness, since the ventricles very rarely contract without a stimulus from the sinus node. An artificial pacemaker can eliminate this problem and normalize heart function.

Palpitations – tachycardia

• Supraventricular tachycardias

hearts and stomachs. The first signs of atrial fibrillation of the heart are usually detected on the ECG. Atrial fibrillation can be permanent or paroxysmal (periodic) form, which determines the approach to treatment. Sinus tachycardia – rapid heartbeat with the formation of the correct complexes on the ECG. Sinus arrhythmia is usually associated with an emotional background, fever, endocrine diseases of the thyroid gland, as well as the predominance of the sympathetic autonomic nervous system.

• Atrial flutter

For atrial flutter to occur, an additional or early electrical impulse must travel around the atrium in a circular path rather than its normal path. This electrical signal causes a very rapid atrial contraction, which is not usually life-threatening, but can cause chest pain, dizziness, or other more serious problems. Many chronic heart diseases lead to the development of flutter and atrial fibrillation – its varieties.

• Atrial fibrillation

Ischemic heart disease often leads to arrhythmia. This common form of tachycardia is more common in women and is manifested by excessive electrical activity in the atria, which is extremely disorganized. The manifestation of this electrical activity is very frequent and chaotic atrial contractions. The atria lose their contractile function, which leads to stagnation of blood in them and can contribute to the formation of clots. Thrombi are the main cause of complications and the danger of atrial fibrillation, since they can break away from the atria and enter the general circulation. Such a blood clot can cause a blockage in any artery in the body (an embolism), leading to a stroke or gangrene in the limbs.

• Paroxysmal supraventricular tachycardia (PSVT)

With PSVT, there is an increase in heart rate from 140 to 250 beats per minute (against the norm of 60-90 beats per minute). Why does this condition happen, cause trouble, but rarely life-threatening? The causes of this type of cardiac arrhythmia are associated with congenital additional electrical pathways between the atria and ventricles. Idiopathic supraventricular tachycardia is treated by destroying accessory electrical pathways using radiofrequency ablation. Tachycardia is felt as an increased heartbeat and is very disturbing for patients.

• Wolff-Parkinson-White (WPW) syndrome

In people with Wolff-Parkinson-White syndrome (WPW), extra, abnormal electrical pathways in the heart lead to periods of very fast heartbeat (tachycardia). Most people with WPW syndrome can lead normal lives. Many have no symptoms and no episodes of tachycardia. In some people, WPW syndrome can cause a rapid heart rate (paroxysmal supraventricular tachycardia) when the heart rate rises to 240 beats per minute (normal is 60 to 80 beats per minute). Other symptoms include palpitations, shortness of breath, fainting, and angina (chest pain) on exertion. The first symptoms of this form of cardiac arrhythmia do not always require treatment, but a thorough examination by a cardiologist is necessary.

• Ventricular tachycardia

Ventricular tachycardia occurs when the ventricles (lower chambers of the heart) contract too fast, which is life threatening. This condition can be very serious, as the ventricles are responsible for pumping blood to the rest of the body. If the tachycardia becomes so severe that the ventricles cannot pump blood effectively, it can be life-threatening. Tachycardia can be treated with medication. Other procedures include implantation of a defibrillator, catheter radiofrequency ablation, or surgical removal of accessory pathways of the heart.
Ventricular extrasystole – arrhythmia of the heart, which manifests itself as a sudden severe interruption in the work of the heart. It is clearly visible on the ECG and interrupts the normal heart rhythm. Bigemenia – one extrasystole through each normal cardiac cycle. Trigemenia – extrasystole after two normal cycles. This poor prognostic sign is of great importance and requires immediate contact with a cardiologist.

• Ventricular fibrillation

Chaotic and inefficient ventricular contractions occur when the electrical signal that normally causes the heart to beat breaks down and travels in random trajectories around the ventricles instead of following its usual route. The result is a series of rapid but ineffective contractions of the ventricles, resulting in loss of consciousness as a result of a sharp drop in blood pressure. This means that without emergency treatment, fibrillation becomes fatal, as it turns off the pumping function of the heart and stops blood circulation. Fibrillation can be stopped with an electrical discharge or a blow to the heart area using a defibrillator. The discharge allows you to “reset” the electrical activity of the heart and return to a normal rhythm. Ventricular fibrillation occurs with myocardial infarction, severe chronic heart disease, hemorrhagic shock, intracardiac procedures.

Forecast

Cardiac arrhythmias are dangerous because they can lead to sudden cardiac arrest due to complete blockade of conduction. In severe arrhythmias, the likelihood of ventricular fibrillation with a fatal outcome is high. Atrial fibrillation leads to the formation of blood clots in the atria and their transfer to other organs with the development of stroke and gangrene of the extremities.