Rapid Heartbeat: Causes, Effects, and Treatment Options

Tachycardia

Hello Doctor: I have been experiencing rapid heartbeats, with my resting heart rate consistently in the range of 100 to 110 beats per minute.
This has been ongoing for several years without any discomfort.
However, three years ago, while shopping, my heart suddenly raced, and it felt like it was going to jump out of my chest.
I couldn't even count my pulse, so I went to the nearest hospital's emergency department and took a heart rhythm medication.
Upon arrival, my blood pressure was 156/96, and my pulse was 156.
The doctor asked the nurse to prepare for an injection.
During the electrocardiogram (ECG), my heart rate decreased slightly to 126 beats per minute, so I did not receive the injection and was allowed to rest for half an hour before going home.
The doctor prescribed me heart rhythm medication and advised me to take it when my heart rate is fast, but I usually have a heart rate above 100.
Should I take it only when I feel chest tightness, or should I take it regularly? I have undergone an ECG, a 24-hour Holter monitor, and an echocardiogram, which were mostly normal except for a few instances of arrhythmia.
The echocardiogram also indicated mild tricuspid regurgitation.
I would like to ask if tricuspid regurgitation could cause my rapid heart rate.
The doctor explained that about 15% of blood may regurgitate, which is not a major concern.
I would like to know if my rapid heart rate is related to the valve issue.
If it is not related, what could be causing my rapid heart rate? Additionally, what are the long-term effects of having such a high heart rate on my heart? How should it be treated? I have many questions, and I kindly ask for your assistance.
Thank you.

Mr. Wang, 40~49 year old female. Ask Date: 2016/05/06

Dr. He Dongjin reply Cardiology

Hello, the ultrasound shows mild tricuspid regurgitation, which is not related to the rapid heartbeat.
When experiencing chest discomfort, it is advisable to take medication as needed, but it can also be taken regularly for comfort.
A consistently high heart rate may have implications for the heart, so there is no need to worry about a pulse of 156 beats per minute; however, it is advisable to investigate further for potential arrhythmias.
Changhua Hospital is concerned about your well-being.

Reply Date: 2016/05/06

More Info

Rapid heartbeat, or tachycardia, can be a concerning symptom that may arise from various underlying causes. Understanding these causes, their effects, and potential treatment options is crucial for managing this condition effectively.

Causes of Rapid Heartbeat
1. Physiological Factors:
- Stress and Anxiety: Emotional stress or anxiety can trigger the body's fight-or-flight response, leading to an increased heart rate.

- Physical Activity: Exercise naturally elevates heart rate, but in some individuals, even mild exertion can cause significant increases.

2. Medical Conditions:
- Arrhythmias: Conditions like atrial fibrillation or paroxysmal supraventricular tachycardia (PSVT) can cause episodes of rapid heart rate. These are often characterized by irregular heartbeats that can be triggered by stress, caffeine, or other stimulants.

- Thyroid Disorders: Hyperthyroidism can lead to an increased heart rate due to elevated levels of thyroid hormones.

- Heart Valve Issues: Conditions such as tricuspid regurgitation (as mentioned in your case) can lead to increased workload on the heart, potentially causing a faster heart rate, though it is typically not the primary cause.

- Anemia: Low red blood cell counts can lead to increased heart rate as the heart works harder to deliver oxygen to tissues.

3. Lifestyle Factors:
- Caffeine and Stimulants: Excessive intake of caffeine or other stimulants can lead to increased heart rate.

- Medications: Some medications, including those for asthma or certain antidepressants, can have side effects that include tachycardia.

Effects of Prolonged Rapid Heartbeat
Chronic tachycardia can have several effects on the heart and overall health:
- Increased Cardiac Workload: A consistently high heart rate can lead to increased workload on the heart, potentially resulting in heart muscle fatigue or heart failure over time.

- Risk of Complications: Prolonged periods of rapid heart rate can increase the risk of blood clots, stroke, or other cardiovascular complications, especially if associated with arrhythmias.

Treatment Options
1. Lifestyle Modifications:
- Reducing caffeine intake, managing stress through relaxation techniques, and engaging in regular physical activity can help manage heart rate.

- Avoiding stimulants and ensuring adequate hydration can also be beneficial.

2. Medications:
- Beta-blockers (like Inderal) are commonly prescribed to help manage heart rate and reduce symptoms associated with tachycardia. Your doctor may adjust the dosage based on your response.

- Anti-arrhythmic medications may be considered if arrhythmias are diagnosed.

3. Interventional Procedures:
- If medication is ineffective, procedures such as catheter ablation may be recommended. This involves using radiofrequency energy to destroy small areas of heart tissue that are causing abnormal electrical signals.

4. Monitoring and Follow-Up:
- Regular follow-up with a cardiologist is essential to monitor your condition. This may include periodic echocardiograms, Holter monitors, or exercise stress tests to assess heart function and rhythm.

Conclusion
In your case, while tricuspid regurgitation may contribute to your symptoms, it is unlikely to be the sole cause of your rapid heartbeat. The interplay of anxiety, lifestyle factors, and possibly an underlying arrhythmia should be considered. It is essential to work closely with your healthcare provider to determine the most appropriate treatment plan tailored to your specific situation. Regular monitoring and proactive management can significantly improve your quality of life and reduce the risk of complications associated with tachycardia.

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