Rapid Heartbeat: Causes, Concerns, and Next Steps

Rapid heartbeat, unable to obtain data?

Occasionally, I experience episodes of rapid heartbeat that cause my whole body to shake, and I feel slightly short of breath, but I have no other discomfort.
When my heart rate suddenly increases, I remain very calm.
Blood tests have shown no issues.
I am 158 cm tall and have maintained a weight between 50-55 kg since adulthood.
The first episode occurred over five years ago in the afternoon, with a pulse rate peaking at 180, which returned to normal in about half an hour.
On September 29, 2020, around 9 PM, my pulse was around 140 for over an hour, which startled me, and I lay down to sleep; it later returned to normal (I didn't note the time).
On January 3, 2021, my pulse ranged from 136 to 158 for about four hours (including a nap of over half an hour), but when using a home blood pressure monitor and a Xiaomi smartwatch, I could only measure a few heartbeats, with most readings showing abnormalities and failing to capture data.
The clinic's blood pressure monitor also couldn't provide data.
What possible conditions could this indicate? Are there any dietary restrictions I should follow? Should I go to a small clinic for examination, or go directly to a larger hospital?

Li Xiaorong, 40~49 year old female. Ask Date: 2021/01/05

Dr. He Dongjin reply Cardiology

Hello, please come to the major hospital for a detailed examination to check for paroxysmal arrhythmia.
Changhua Hospital cares about you.

Reply Date: 2021/01/05

More Info

Understanding rapid heartbeat, or palpitations, can be concerning, especially when they occur unexpectedly and with significant intensity. Based on your description, it seems that you have experienced episodes of rapid heart rate (tachycardia) that can reach up to 180 beats per minute, lasting anywhere from half an hour to several hours. While you report feeling calm during these episodes, the physical sensations can be alarming and lead to anxiety about your heart health.

Possible Causes of Rapid Heartbeat
1. Physiological Factors: Rapid heartbeats can be triggered by various physiological factors, including dehydration, electrolyte imbalances, or excessive caffeine intake. Stress and anxiety can also lead to increased heart rates, even if you feel calm at the moment.

2. Cardiac Conditions: Conditions such as atrial fibrillation, supraventricular tachycardia (SVT), or other arrhythmias can cause episodes of rapid heart rate. Given your history of high cholesterol and the fact that you are on medication for blood pressure, it is essential to rule out any underlying cardiac issues.

3. Hormonal Influences: Thyroid disorders, particularly hyperthyroidism, can lead to increased heart rates. It might be worthwhile to have your thyroid levels checked if this has not been done already.

4. Lifestyle Factors: Alcohol, nicotine, and recreational drugs can also contribute to episodes of tachycardia. Monitoring your intake of these substances may provide insight into your symptoms.

Concerns and Next Steps
Given your symptoms and the fact that you have experienced episodes of rapid heartbeat multiple times, it is advisable to seek further evaluation. Here are some steps you can take:
1. Consult a Healthcare Provider: It is important to discuss your symptoms with a healthcare provider, preferably a cardiologist. They can perform a thorough evaluation, including a physical examination and a detailed medical history.

2. Diagnostic Tests: Your doctor may recommend several tests, including:
- Electrocardiogram (EKG): This test records the electrical activity of your heart and can help identify any arrhythmias.

- Holter Monitor: This portable device records your heart's rhythm over 24-48 hours, capturing any irregularities that may not appear during a standard EKG.

- Echocardiogram: This ultrasound test can assess the structure and function of your heart.

3. Lifestyle Modifications: While awaiting your appointment, consider making some lifestyle changes:
- Diet: Reduce caffeine and alcohol intake, as both can exacerbate palpitations. Staying hydrated and maintaining a balanced diet rich in fruits, vegetables, and whole grains can support overall heart health.

- Exercise: Regular physical activity can help improve cardiovascular health, but be cautious with high-intensity workouts if you experience palpitations.

- Stress Management: Techniques such as yoga, meditation, or deep-breathing exercises can help manage stress and anxiety, which may contribute to your symptoms.

4. Emergency Care: If you experience severe symptoms such as chest pain, shortness of breath, or fainting, seek emergency medical attention immediately.

Conclusion
While occasional rapid heartbeats can be benign, the frequency and intensity of your episodes warrant further investigation. By consulting with a healthcare provider and undergoing appropriate testing, you can gain a clearer understanding of your heart health and any necessary interventions. Remember, early detection and management are key to maintaining cardiovascular health.

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