Rapid Heartbeat: Causes, Concerns, and Treatment Options

Heart rate issues?

Recently, I have been feeling my heart beating strongly and quickly.
I went to the hospital for an examination, which included an electrocardiogram (ECG), a stress test, a 24-hour Holter monitor, and X-rays.
The doctor said there were no arrhythmia issues, and my average heart rate is around 90 beats per minute.
He prescribed me Bisoprolol and Atenolol.
Currently, my heart rate fluctuates between 70 and 100 beats per minute, sometimes exceeding 100.
Even when I go for a walk, it can go above 110, reaching up to 128.
Could you please advise me, if my heart is fine, what could be the issue? If this elevated heart rate persists, will it cause any problems for my heart? Should I continue taking the medication?

Niming, 10~19 year old female. Ask Date: 2021/07/30

Dr. He Dongjin reply Cardiology

Hello, the electrocardiogram (ECG), exercise ECG, and 24-hour Holter monitor, as well as the X-ray, show no arrhythmias.
If these tests are normal, the heart should be fine.
It is likely that the symptoms are caused by autonomic nervous system dysregulation, which can sometimes lead to a heart rate exceeding 100 beats per minute.
Prolonged elevated heart rates typically do not indicate heart problems, so there is no need to worry.
You can choose to take medication or not, depending on what makes you feel comfortable.
You may take the medication if symptoms arise.
Take care, and this is from Changhua Hospital.

Reply Date: 2021/07/30

More Info

Rapid heartbeat, or tachycardia, can be a concerning symptom for many individuals, especially when it feels forceful or irregular. Understanding the underlying causes, potential risks, and treatment options is crucial for managing this condition effectively.

Based on your description, it seems that you've undergone a comprehensive evaluation, including an electrocardiogram (ECG), exercise stress test, 24-hour Holter monitor, and chest X-ray, all of which returned normal results. This is reassuring, as it indicates that there are no significant arrhythmias or structural heart issues present. The average heart rate of 90 beats per minute (bpm) that you mentioned is slightly elevated but can be influenced by various factors, including anxiety, stress, physical activity, and even caffeine intake.

Causes of Rapid Heartbeat:
1. Physiological Factors: Physical exertion, emotional stress, and anxiety can all lead to an increased heart rate. It is not uncommon for individuals to experience heart rates exceeding 100 bpm during activities like walking or exercising, especially if they are not accustomed to regular physical activity.

2. Medications: Certain medications can also affect heart rate. The medications you mentioned, such as Bisoprolol (合必爽) and Amlodipine (贊安諾), are typically used to manage blood pressure and heart rate. They can help stabilize your heart rhythm and reduce episodes of tachycardia.

3. Autonomic Nervous System: The autonomic nervous system, which regulates involuntary bodily functions, can also play a role. Stress and anxiety can trigger the sympathetic nervous system, leading to an increased heart rate.

4. Lifestyle Factors: Consumption of stimulants like caffeine, nicotine, and certain medications can also contribute to a rapid heartbeat.

Concerns:
While your tests indicate that there are no underlying heart conditions, persistent tachycardia can lead to potential complications over time. Chronic elevated heart rates can strain the heart, potentially leading to issues such as cardiomyopathy or heart failure if left unaddressed. However, given your normal test results, the immediate risk appears low.

Self-Management and Treatment Options:
1. Medication Adherence: It is essential to continue taking your prescribed medications as directed by your healthcare provider. These medications can help manage your heart rate and prevent episodes of tachycardia.

2. Lifestyle Modifications: Consider incorporating stress-reduction techniques such as mindfulness, yoga, or meditation into your daily routine. Regular physical activity can also help improve cardiovascular health and reduce anxiety.

3. Dietary Changes: Monitor your caffeine and alcohol intake, as these can exacerbate heart rate issues. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall heart health.

4. Regular Monitoring: Keep track of your heart rate and any symptoms you experience. If you notice significant changes or worsening symptoms, consult your healthcare provider for further evaluation.

When to Seek Further Help:
If you experience symptoms such as chest pain, shortness of breath, dizziness, or fainting, it is crucial to seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

In conclusion, while your heart appears to be functioning normally based on your tests, managing your heart rate and overall health through lifestyle changes, medication adherence, and regular follow-ups with your healthcare provider is essential. If you have any concerns about your medications or symptoms, do not hesitate to discuss them with your doctor for personalized advice.

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