Rapid Heartbeat: Causes, Symptoms, and Solutions - Cardiology

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Rapid heartbeat?


I often experience palpitations, sometimes when I need to use the restroom, sometimes when I'm anxious, and also during exercise.
I have undergone an electrocardiogram and echocardiogram, which showed no significant issues.
My resting heart rate is around 80 beats per minute, but during episodes, my heart rate increases to 120-150 beats per minute, making me feel very uncomfortable.
Could this be considered autonomic nervous system dysfunction? However, the frequency is quite high and it has already affected my daily life.
What are some ways to address this?

Helen, 30~39 year old female. Ask Date: 2020/05/13

Dr. Huang Yinghe reply Cardiology


Hello: It could be paroxysmal arrhythmia.
If an electrocardiogram (ECG) can be recorded during an episode, or if a 24-hour Holter monitor is performed, it would help determine the type of arrhythmia.
Sometimes, it may also be related to stress or emotional symptoms, and it doesn't necessarily indicate a heart problem.
A confirmed diagnosis is needed to determine the appropriate management, so please discuss with your physician whether further testing is necessary.

Reply Date: 2020/05/13

More Info


Experiencing rapid heartbeat, or palpitations, can be a concerning symptom, especially when it occurs frequently and impacts your daily life. Based on your description, it seems that your heart rate can spike significantly during moments of stress, physical activity, or even when you feel the need to use the restroom. While you have undergone tests such as an electrocardiogram (ECG) and echocardiogram that did not reveal any significant issues, the symptoms you are experiencing could indeed be related to autonomic nervous system dysregulation, commonly referred to as autonomic dysfunction.

The autonomic nervous system (ANS) controls involuntary bodily functions, including heart rate, blood pressure, and digestion. It consists of two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' activities. An imbalance in these systems can lead to symptoms such as rapid heartbeat, anxiety, and even gastrointestinal disturbances.

Your heart rate of 120 to 150 beats per minute during episodes of palpitations is significantly elevated, especially considering your resting heart rate is around 80 beats per minute. This level of tachycardia can cause discomfort and may be accompanied by feelings of anxiety, lightheadedness, or even shortness of breath. It is essential to recognize that while palpitations can be benign, they can also indicate underlying issues, particularly if they are frequent and disruptive.

Given that your symptoms occur during stressful situations or physical exertion, it is plausible that they are exacerbated by anxiety or stress. Stress can trigger the sympathetic nervous system, leading to increased heart rate and palpitations. Additionally, certain lifestyle factors—such as caffeine intake, dehydration, lack of sleep, or even certain medications—can contribute to these episodes.

To address your concerns and manage your symptoms, consider the following strategies:
1. Stress Management Techniques: Incorporate relaxation techniques such as deep breathing exercises, meditation, or yoga into your daily routine. These practices can help activate the parasympathetic nervous system, promoting a sense of calm and potentially reducing the frequency of palpitations.

2. Regular Exercise: Engaging in regular physical activity can improve cardiovascular health and help regulate your heart rate. However, it is essential to listen to your body and avoid overexertion, especially if you notice that exercise triggers your symptoms.

3. Healthy Lifestyle Choices: Maintain a balanced diet, stay hydrated, and limit caffeine and alcohol intake, as these substances can exacerbate palpitations. Ensure you are getting adequate sleep, as fatigue can also contribute to increased anxiety and heart rate.

4. Monitoring Triggers: Keep a diary of your palpitations, noting when they occur, their duration, and any associated activities or feelings. This information can help you identify specific triggers and patterns, which can be valuable for your healthcare provider.

5. Consultation with a Specialist: If your symptoms persist or worsen, consider seeking further evaluation from a cardiologist or a specialist in autonomic disorders. They may recommend additional testing or treatments, such as medication to help manage your heart rate or anxiety.

6. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your symptoms, working with a mental health professional trained in CBT can help you develop coping strategies and reduce anxiety-related palpitations.

In conclusion, while your symptoms may suggest autonomic nervous system dysregulation, it is crucial to approach this issue holistically. By implementing lifestyle changes, managing stress, and seeking professional guidance, you can work towards alleviating your symptoms and improving your quality of life. Always consult with your healthcare provider before making significant changes to your health regimen or if you have concerns about your heart health.

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