Rapid Heartbeat: Causes, Symptoms, and Treatment Options

Rapid heartbeat

Hello Dr.
Wu, I was diagnosed with mitral valve insufficiency around the age of 20, but it hasn't significantly affected my daily life.
I also had hyperthyroidism, which is now under control.
My resting heart rate has consistently been on the higher side, ranging from 80 to 95 beats per minute, and my blood pressure is generally normal, sometimes slightly low.
I rarely exercise, but a few days ago, after climbing several flights of stairs, I experienced severe discomfort in my heart, feeling as if it was going to explode, although it normalized after resting for ten minutes.

The next morning, I suddenly started experiencing chest tightness, and by 3 PM, my heart rate escalated from 100 to 149 beats per minute, accompanied by dizziness and difficulty breathing, which led to an emergency room visit.
After taking one dose of Propranolol, my symptoms gradually eased.
Currently, I take one pill three times a day, and my heart rate decreases from 100 to 77 after taking the medication, but it tends to increase again over time, followed by another quick relief after taking the medication.

I've noticed that my heart feels particularly uncomfortable in poorly ventilated environments, while temperature changes do not seem to have a significant effect.
I would like to know what might be causing these symptoms and whether long-term medication can help manage this condition.
I have had blood tests done and am waiting for the results to confirm if hyperthyroidism has recurred.
What additional tests should I undergo at the hospital? Thank you for your response, doctor.

Niming, 40~49 year old female. Ask Date: 2021/04/14

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 monitoring thyroid function and a 24-hour Holter monitor.

Reply Date: 2021/04/14

More Info

Hello! Thank you for sharing your concerns regarding your heart health. Based on your description, it seems you are experiencing episodes of rapid heartbeat (tachycardia), chest discomfort, and dizziness, particularly after physical exertion or in environments with poor air circulation. Let's break down the potential causes, symptoms, and treatment options for your situation.

Possible Causes of Rapid Heartbeat
1. Valvular Heart Disease: You mentioned a history of mitral regurgitation. While many individuals with this condition live without significant symptoms, it can lead to increased workload on the heart, especially during physical activity. This could explain the discomfort you felt after climbing stairs.

2. Hyperthyroidism: Your previous diagnosis of hyperthyroidism could also contribute to an elevated heart rate. Even if your thyroid levels are currently controlled, fluctuations can occur, leading to symptoms like palpitations and increased heart rate.

3. Anxiety and Stress: Psychological factors can significantly impact heart rate. Anxiety can lead to episodes of tachycardia, especially in stressful situations or after physical exertion.

4. Dehydration or Electrolyte Imbalance: If you are not adequately hydrated, especially after physical activity, this can lead to increased heart rate and dizziness.

5. Autonomic Nervous System Dysfunction: Conditions affecting the autonomic nervous system can lead to inappropriate heart rate responses, especially in response to physical activity or environmental changes.

Symptoms to Monitor
- Chest Discomfort: This can be a sign of various conditions, including cardiac issues. It's essential to differentiate between musculoskeletal pain and potential cardiac-related discomfort.

- Dizziness and Shortness of Breath: These symptoms, especially when associated with rapid heart rate, warrant further investigation.

- Response to Medication: You mentioned that Propranolol helps to manage your heart rate. This beta-blocker is effective in controlling tachycardia and can also help with anxiety-related symptoms.

Recommended Tests and Follow-Up
1. Thyroid Function Tests: Since you are awaiting results to check for potential hyperthyroidism recurrence, this is crucial. Elevated thyroid hormones can lead to increased heart rate and other symptoms.

2. Electrocardiogram (ECG): A resting ECG can help identify any arrhythmias or other electrical issues with your heart.

3. Holter Monitor: A 24-hour Holter monitor can provide insight into your heart's rhythm over a more extended period, capturing any episodes of tachycardia or irregular heartbeats.

4. Echocardiogram: This ultrasound of the heart can assess the function of your heart valves and overall heart structure, especially considering your history of mitral regurgitation.

5. Exercise Stress Test: This test can evaluate how your heart responds to physical exertion and help identify any exercise-induced arrhythmias.

Long-Term Management
- Medication: Propranolol is commonly prescribed for managing tachycardia and can be effective in controlling symptoms. Long-term use is generally safe, but regular follow-up with your healthcare provider is essential to monitor its effectiveness and any potential side effects.

- Lifestyle Modifications: Incorporating regular physical activity, maintaining hydration, and managing stress through techniques such as mindfulness or yoga can be beneficial. Avoiding stimulants like caffeine and ensuring good air circulation in your environment may also help.

- Regular Monitoring: Keep track of your symptoms, heart rate, and any triggers that exacerbate your condition. This information can be valuable for your healthcare provider in managing your treatment plan.

In conclusion, while your symptoms may be concerning, they can often be managed effectively with appropriate medical care and lifestyle adjustments. It's essential to maintain open communication with your healthcare provider and follow through with the recommended tests to ensure your heart health is monitored closely. If you experience any new or worsening symptoms, do not hesitate to seek immediate medical attention.

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