Sudden Heart Rate Increases: When to Seek Medical Advice

Sudden increase in heart rate?

Recently, when measuring my heart rate with a Xiaomi device, it sometimes suddenly exceeds 100, reaching as high as 190.
It also spikes over 100 during the night, and I don't feel any discomfort or notice an increased heartbeat at that time.
Occasionally, I experience sharp pain in my left chest, along with a feeling of pressure in my chest and difficulty breathing.
A year ago, I consulted a cardiologist and underwent an electrocardiogram (ECG), a stress test, a 24-hour Holter monitor, and an echocardiogram.
They noted a couple of instances of arrhythmia but found no other issues.
I also saw a pulmonologist who indicated that my chest pain is due to scoliosis affecting my muscles, and that my breathing difficulties are related to nasal polyps.
However, my heart rate has been feeling irregular again recently.
Should I return to the cardiologist for another examination? Thank you for your response.

Ms. Chen, 30~39 year old female. Ask Date: 2021/06/30

Dr. He Dongjin reply Cardiology

Hello, your heart rate exceeds 100, with a maximum of 190.
It is difficult to determine if there is an arrhythmia.
It is advisable to follow up with a cardiologist for further evaluation.
Ping An Changhua Hospital cares about you.

Reply Date: 2021/06/30

More Info

When it comes to sudden increases in heart rate, especially when accompanied by symptoms such as chest pain, pressure, or shortness of breath, it is essential to take these signs seriously. Your experience of occasionally measuring your heart rate above 100 beats per minute, with peaks reaching 190, can be concerning, particularly if you also experience left chest pain and difficulty breathing.
Given your medical history, including previous evaluations by a cardiologist and a pulmonologist, it seems that you have already undergone a comprehensive assessment. The fact that your heart rate irregularities were noted but deemed not to be of significant concern at that time is reassuring. However, the recurrence of symptoms warrants further attention.

Understanding Heart Rate Increases
1. Normal Variability: Heart rate can fluctuate due to various factors, including physical activity, emotional stress, caffeine intake, and even sleep patterns. However, a resting heart rate exceeding 100 beats per minute, particularly if it occurs frequently or suddenly, may indicate an underlying issue.

2. Potential Causes:
- Arrhythmias: These are irregular heartbeats that can cause palpitations or a racing heart. While you have had some irregularities noted in your previous tests, the absence of significant findings suggests that these may not be life-threatening. However, they can still cause discomfort and anxiety.

- Anxiety and Stress: Psychological factors can significantly impact heart rate. Anxiety can lead to episodes of tachycardia (rapid heart rate) and may also contribute to sensations of chest pressure or pain.

- Musculoskeletal Issues: As noted by your pulmonologist, conditions like scoliosis can lead to muscle strain or nerve compression, which might manifest as chest pain or discomfort.

- Respiratory Conditions: Nasal polyps and other respiratory issues can lead to difficulty breathing, which may exacerbate feelings of anxiety and contribute to a racing heart.

When to Seek Medical Advice
Given your symptoms and the recent changes in your heart rate, it is advisable to consult with a cardiologist again. Here are some specific reasons to seek further evaluation:
- New or Worsening Symptoms: If you notice an increase in the frequency or severity of your symptoms, such as chest pain, pressure, or shortness of breath, it is crucial to get evaluated.

- Persistent Tachycardia: If your heart rate frequently exceeds 100 beats per minute, especially at rest, this should be investigated further.

- Associated Symptoms: The presence of left-sided chest pain and difficulty breathing, even if they are intermittent, should not be ignored. These symptoms could indicate a need for further cardiac evaluation.

- Previous Findings: Since you have a history of heart rate irregularities, it is prudent to follow up with your cardiologist to reassess your heart health.

Recommended Actions
1. Schedule a Follow-Up Appointment: Contact your cardiologist to discuss your recent symptoms and any changes in your heart rate. They may recommend additional tests, such as a repeat echocardiogram or a 24-hour Holter monitor to capture your heart's activity over an extended period.

2. Monitor Your Symptoms: Keep a log of your heart rate readings, symptoms, and any potential triggers (like stress or caffeine consumption). This information can be valuable for your healthcare provider.

3. Lifestyle Modifications: Consider lifestyle changes that may help manage your symptoms, including stress reduction techniques, regular exercise, and a balanced diet. Reducing caffeine and alcohol intake can also be beneficial.

4. Stay Informed: Educate yourself about your condition and potential symptoms to better communicate with your healthcare provider.

In summary, while your previous evaluations may not have indicated severe issues, the recurrence of symptoms and changes in your heart rate merit further investigation. It is always better to err on the side of caution when it comes to heart health.

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