Rapid Heartbeat: Risks and Management for Patients

Tachycardia

Hello Doctor, I discovered at the end of March that my heart rate is somewhat elevated.
I have a problem with obesity and hypertension (which I manage with medication).
In the morning, my heart rate is around 80-100 bpm, close to noon it ranges from 95-110 bpm, and in the evening it is between 75-100 bpm.
I do not feel any discomfort.
I have visited a major hospital where I underwent an echocardiogram, blood tests, and a 24-hour Holter monitor.
During my follow-up, the doctor mentioned that I have occasional premature contractions, but they are very mild, occurring less than 20 times a day.
Therefore, the doctor did not prescribe any medication.
I would like to ask if my heart rate requires medication for control.
If left uncontrolled, is there any long-term risk associated with this heart rate? Thank you.

AAA, 20~29 year old female. Ask Date: 2019/04/17

Dr. He Dongjin reply Cardiology

Hello, if there is no arrhythmia and the heart rate is simply elevated without any issues, there is no need to worry.
However, if you still cannot find peace of mind, you may ask your physician to adjust your blood pressure medication to one that can simultaneously control both blood pressure and heart rate.
Changhua Hospital cares about you.

Reply Date: 2019/04/17

More Info

Understanding rapid heartbeat, or tachycardia, is crucial for patients, especially those with underlying health conditions such as obesity and hypertension. Your situation, characterized by a heart rate ranging from 80 to 110 beats per minute throughout the day, is indeed noteworthy, particularly since you have been diagnosed with occasional premature contractions (PVCs) that are considered mild.

Risks Associated with Rapid Heartbeat
1. Cardiovascular Strain: A consistently elevated heart rate can lead to increased workload on the heart. Over time, this may contribute to heart muscle fatigue or even heart failure, particularly in individuals with pre-existing conditions like hypertension.

2. Increased Risk of Arrhythmias: While your doctor noted that your premature contractions are infrequent and mild, a rapid heartbeat can sometimes lead to more serious arrhythmias. This is especially true if the heart is under stress or if there are other underlying issues.

3. Potential for Reduced Cardiac Output: If the heart beats too quickly, it may not have enough time to fill with blood between beats, potentially leading to decreased cardiac output. This can result in symptoms such as dizziness, fatigue, or even fainting, although you have not reported these symptoms.

4. Long-term Effects: Chronic tachycardia can lead to structural changes in the heart, including hypertrophy (thickening of the heart muscle) and dilation, which can further complicate heart function.

Management Strategies
1. Lifestyle Modifications: Since you mentioned obesity, weight management through a balanced diet and regular exercise can significantly improve your heart health. Even moderate physical activity can help lower resting heart rates and improve overall cardiovascular fitness. However, it is essential to consult with your healthcare provider before starting any new exercise regimen, especially given your concerns about rapid heart rates during physical activity.

2. Monitoring: Regular follow-ups with your healthcare provider are essential. Since your heart rate is being monitored, it’s crucial to keep track of any changes or new symptoms that may arise. If your heart rate consistently exceeds 100 beats per minute at rest or if you experience any new symptoms, further evaluation may be warranted.

3. Medication Considerations: Your doctor has not prescribed medication due to the mild nature of your symptoms. However, if your heart rate continues to be a concern, or if you start experiencing symptoms like palpitations, dizziness, or chest pain, it may be worth discussing the possibility of medication to help control your heart rate. Beta-blockers, for instance, are commonly used to manage tachycardia and can provide additional benefits for patients with hypertension.

4. Stress Management: Anxiety and stress can exacerbate heart rate issues. Techniques such as mindfulness, yoga, or cognitive behavioral therapy can be beneficial in managing stress levels, which may help in controlling your heart rate.

5. Regular Check-ups: Continue to have regular check-ups with your cardiologist. They may recommend additional tests, such as an echocardiogram or a stress test, to ensure that your heart is functioning well and to rule out any underlying conditions that may require treatment.

Conclusion
In summary, while your current heart rate and the presence of mild premature contractions do not seem to warrant immediate medication, it is essential to maintain a proactive approach to your cardiovascular health. Regular monitoring, lifestyle changes, and open communication with your healthcare provider will be key in managing your heart health effectively. If you have any concerns or if your symptoms change, do not hesitate to reach out to your doctor for further evaluation and guidance.

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