Fast Heart Rate: When to Seek Further Cardiac Evaluation

Tachycardia

Hello, doctor.
I have had a history of tachycardia since childhood, with my heart rate consistently above 90 even at rest or when I am about to fall asleep.
When walking, it often exceeds 100.
Although these numbers seem to fall within the normal range, a doctor at a clinic once mentioned that having a consistently elevated heart rate could impact my health in the long term.
There is no family history of heart disease, and aside from the elevated heart rate, my electrocardiogram did not reveal any abnormalities.
My overall health is good, but I do feel that my stamina is lower than that of my peers, and I often experience feelings of hypoxia and occasional episodes of arrhythmia under stress.
I would like to ask if I need to undergo more detailed cardiac examinations.
Are there any ways to improve this condition, such as through aerobic exercise?

Anna, 20~29 year old female. Ask Date: 2020/12/23

Dr. Wu Xueming reply Cardiology

Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages.
It is recommended to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is advisable to visit a hospital for an electrocardiogram (ECG) examination.

Reply Date: 2020/12/23

More Info

Understanding a fast heart rate, or tachycardia, is crucial for maintaining cardiovascular health. Tachycardia is generally defined as a resting heart rate exceeding 100 beats per minute (bpm). While it can be a normal physiological response to exercise, stress, or excitement, persistent tachycardia, especially at rest, can indicate underlying health issues that may require further evaluation.

In your case, you mentioned experiencing a resting heart rate consistently above 90 bpm, with rates exceeding 100 bpm during light activities like walking. Although your heart rate falls within the upper limits of normal, it is essential to consider the context and any accompanying symptoms. Factors such as age, fitness level, and overall health can influence what is considered a normal heart rate for you.

Given your history of elevated heart rates, occasional feelings of oxygen deprivation, and episodes of palpitations, it would be prudent to seek further cardiac evaluation. While your previous electrocardiograms (ECGs) have not shown any abnormalities, the persistence of symptoms warrants a comprehensive assessment. Here are some potential evaluations and considerations:
1. Holter Monitor: This device records your heart's activity over 24 to 48 hours, providing a more extended view of your heart rhythm and identifying any irregularities that might not appear during a standard ECG.

2. Exercise Stress Test: This test evaluates how your heart responds to physical exertion. It can help determine if your heart rate increases appropriately during exercise and whether there are any concerning changes in heart rhythm or blood pressure.

3. Echocardiogram: An ultrasound of the heart can assess its structure and function, checking for any abnormalities in the heart valves or chambers that might contribute to your symptoms.

4. Blood Tests: Thyroid function tests and other blood work can help identify metabolic issues that might be causing your elevated heart rate.

5. Lifestyle Modifications: Engaging in regular aerobic exercise can help improve your cardiovascular fitness and may lead to a lower resting heart rate over time. Activities such as walking, jogging, cycling, or swimming can enhance your heart's efficiency. Additionally, practicing stress-reduction techniques such as yoga, meditation, or deep-breathing exercises can help manage anxiety and its impact on heart rate.

6. Hydration and Nutrition: Ensuring adequate hydration and a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall heart health. Avoiding stimulants like caffeine and nicotine may also help regulate your heart rate.

7. Monitoring and Follow-Up: Keeping a record of your heart rate and any symptoms you experience can provide valuable information for your healthcare provider. Regular follow-ups can help track any changes in your condition and adjust your management plan accordingly.

In summary, while your heart rate may be within a normal range, the persistence of symptoms and the impact on your quality of life suggest that further evaluation is warranted. Engaging in a discussion with your healthcare provider about your symptoms and concerns will help determine the most appropriate next steps for your cardiac health. Remember, proactive management and lifestyle changes can significantly improve your overall well-being and potentially mitigate future cardiovascular risks.

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