Rapid Heartbeat: Causes and Solutions for Young Adults

Tachycardia

Hello, doctor.
I am currently 19 years old and have autonomic nervous system dysfunction and panic disorder.
Before experiencing these symptoms, my heart rate was 85 beats per minute, but now during a panic attack, I experience palpitations, and my heart rate can increase to 140 beats per minute due to my anxious personality.
Sometimes, I feel short of breath even when walking, and I also experience chest pain during exercise, which makes me hesitant to engage in vigorous activities.
A previous health check indicated that I do not have arrhythmia, and my blood pressure was 123/89, with a heart rate of 137.
Is this normal? What could be the cause? How can I improve my condition? Thank you.

xin, 10~19 year old female. Ask Date: 2020/02/24

Dr. Lin Jixiong reply Cardiology

Tachycardia, defined as a heart rate exceeding 100 beats per minute, is often referred to as "sinus tachycardia" and is usually benign.
Factors such as stress, consumption of tea, alcohol, tobacco, coffee, hyperthyroidism, or heightened sympathetic or vagal nerve activity can lead to an increased heart rate.
If reducing stress and limiting alcohol intake do not improve the condition, it may indicate a warning from the body, such as myocardial ischemia or early signs of heart failure.
Therefore, if symptoms persist, it is advisable to consult a cardiologist for a thorough examination.
Chest pain can be categorized as either cardiac or non-cardiac.
Cardiac chest pain, commonly known as angina pectoris, typically has the following characteristics: 1.
It lasts for several minutes (2-10 minutes), is described as pressure or tightness, and may cause shortness of breath (like an elephant sitting on the chest).
2.
It may radiate to the jaw, left arm, or other areas.
3.
It is usually triggered by physical activity or emotional stress and improves with rest.
4.
It is more common in patients with risk factors for coronary artery disease, such as age (men >45 years or women >55 years or postmenopausal), hypertension, hyperlipidemia, diabetes, smoking, a family history of early coronary artery disease, and a sedentary lifestyle.
Based on your symptom description, it does not align with typical angina pectoris, so you can feel reassured.
However, if symptoms persist, it is still recommended to seek a detailed examination from a cardiologist.
Dr.
Hsueh-Ming Wu, Department of Cardiology, Taoyuan Hospital.

Reply Date: 2020/02/24

More Info

Understanding rapid heartbeat, especially in young adults, can be a complex issue that often involves multiple factors, including anxiety, lifestyle choices, and underlying medical conditions. Based on your description, it seems you are experiencing symptoms related to autonomic nervous system dysregulation and panic disorder, which can significantly affect your heart rate and overall well-being.

Firstly, it's important to recognize that a resting heart rate of 85 beats per minute is within the normal range, though it is on the higher side. During panic attacks or episodes of anxiety, it is common for the heart rate to increase significantly, sometimes reaching 140 beats per minute or more. This is a physiological response to stress, where the body prepares for a "fight or flight" reaction. The symptoms you describe, such as feeling short of breath and experiencing chest pain during physical activity, can be alarming, but they are often linked to anxiety rather than a direct cardiac issue, especially since previous health checks indicated no arrhythmias.

Your blood pressure reading of 123/89 mmHg is also considered normal, although the diastolic number (the second number) is slightly elevated. This could be a reflection of your anxiety levels, as stress can temporarily raise blood pressure. It’s crucial to manage your anxiety and stress levels, as they can exacerbate your symptoms.

Here are some strategies to help manage your symptoms:
1. Cognitive Behavioral Therapy (CBT): This form of therapy is effective for treating anxiety and panic disorders. It helps you identify and change negative thought patterns that contribute to your anxiety.

2. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, and yoga can help calm your mind and reduce the physiological symptoms of anxiety.

3. Regular Physical Activity: While you may be hesitant to engage in vigorous exercise due to your symptoms, regular moderate exercise can actually help reduce anxiety and improve heart health. Start with low-impact activities like walking or swimming, and gradually increase the intensity as you feel more comfortable.

4. Healthy Lifestyle Choices: Pay attention to your diet, ensuring you consume a balanced intake of nutrients. Limit caffeine and sugar, as these can exacerbate anxiety and lead to increased heart rate. Staying hydrated and getting adequate sleep are also essential for managing stress.

5. Medication: If your symptoms are significantly impacting your daily life, you may want to discuss medication options with your healthcare provider. Medications such as SSRIs or beta-blockers can help manage anxiety and its physical symptoms.

6. Monitoring Symptoms: Keeping a diary of your symptoms, including when they occur and any potential triggers, can help you and your healthcare provider identify patterns and develop a more tailored treatment plan.

7. Consult a Specialist: If your symptoms persist or worsen, consider consulting a cardiologist or a mental health professional who specializes in anxiety disorders. They can provide further evaluation and treatment options.

In conclusion, while your symptoms are understandably concerning, they are likely related to anxiety and not indicative of a serious heart condition, especially given your previous health evaluations. By implementing coping strategies and seeking appropriate support, you can work towards managing your symptoms effectively. Remember, it's essential to communicate openly with your healthcare provider about your concerns and treatment options.

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