Sudden Rapid Heartbeats: Causes and Relief Strategies

Sometimes the heartbeat is very fast and strong, and there is also a sensation of missed beats?

Hello, doctor.
Sometimes my heart suddenly beats very fast and strongly, lasting about 15 to 20 minutes.
I tend to sweat profusely when I feel anxious, but there is no pain.
Usually, these episodes occur when I'm not doing anything, like watching TV or scrolling on my phone before bed.
Additionally, I consider myself an athlete.
During my military physical examination last year, I was diagnosed with left ventricular hypertrophy, but the doctor said it was nothing to worry about during my follow-up visit.
I have experienced chest pain in the past, but it typically lasts only 5 to 10 minutes before resolving.
Furthermore, I fainted when I was younger, and after undergoing an electrocardiogram at the hospital, the doctor found no abnormalities.
I would like to know what these symptoms might indicate and how I can alleviate them.

Qiqi, 10~19 year old female. Ask Date: 2021/08/14

Dr. He Dongjin reply Cardiology

Hello, at 19 years old, experiencing sudden episodes of rapid and forceful heartbeats may be related to anxiety.
The chest pain you mentioned is quite common at this age, especially among athletes, who often perform well in sports.
The likelihood of having a heart problem is low.
Have you fainted when you were younger? If that hasn't occurred again as you've grown older, it's hard to determine the cause.
If you are still concerned, it is advisable to consult a cardiologist for further evaluation.
Changhua Hospital cares about your well-being.

Reply Date: 2021/08/14

More Info

Understanding sudden rapid heartbeats, also known as palpitations, can be a source of anxiety for many individuals. These episodes can be triggered by various factors, including stress, anxiety, physical exertion, or underlying medical conditions. Given your background as an athlete and the history of left ventricular hypertrophy (LVH), it’s essential to consider both physiological and psychological aspects when addressing your concerns.

Causes of Sudden Rapid Heartbeats
1. Physiological Factors: As an athlete, your heart is conditioned to handle physical stress, but it can still respond to emotional stressors. Rapid heartbeats can occur during periods of rest, especially if you are experiencing anxiety or stress. The sympathetic nervous system, which governs the fight-or-flight response, can become activated even in non-threatening situations, leading to palpitations.

2. Medical Conditions: Left ventricular hypertrophy can be a response to chronic high blood pressure or intense physical training. While your doctor indicated that it is not a concern, it is crucial to monitor your heart health regularly. Other potential causes of palpitations include:
- Arrhythmias: Irregular heartbeats can manifest as sudden rapid heartbeats. While you mentioned that previous tests did not reveal abnormalities, it may be worthwhile to have periodic evaluations, especially if symptoms persist.

- Electrolyte Imbalances: Low levels of potassium, magnesium, or calcium can affect heart rhythm.

- Thyroid Issues: Hyperthyroidism can lead to increased heart rate and palpitations.

3. Lifestyle Factors: Caffeine, nicotine, alcohol, and certain medications can also trigger palpitations. As an athlete, it’s essential to maintain a balanced diet and stay hydrated, as dehydration can exacerbate heart rhythm issues.

Relief Strategies
1. Breathing Techniques: When you feel a rapid heartbeat, practicing deep breathing exercises can help calm your nervous system. Inhale deeply through your nose, hold for a few seconds, and exhale slowly through your mouth. This can help reduce anxiety and slow your heart rate.

2. Regular Exercise: While you are already active, incorporating relaxation-focused activities such as yoga or tai chi can help manage stress and improve your overall cardiovascular health.

3. Avoid Stimulants: Reducing or eliminating caffeine and nicotine can decrease the frequency of palpitations. Monitor your intake of these substances and see if there’s an improvement.

4. Stay Hydrated: Ensure you are drinking enough water, especially if you are active. Dehydration can lead to increased heart rate and palpitations.

5. Monitor Your Heart Rate: Keeping track of your heart rate during different activities can provide insights into when and why your heart races. If you notice patterns, it may help you identify triggers.

6. Consult a Specialist: If your symptoms persist or worsen, consider consulting a cardiologist or an electrophysiologist. They may recommend further testing, such as an echocardiogram or a Holter monitor, to assess your heart's rhythm over an extended period.

Conclusion
While occasional rapid heartbeats can be benign, especially in the context of anxiety or stress, it’s essential to remain vigilant about your heart health, particularly given your history of left ventricular hypertrophy. Implementing stress-reduction techniques, maintaining a healthy lifestyle, and seeking regular medical advice will help you manage your symptoms effectively. If you experience any alarming symptoms, such as chest pain, fainting, or prolonged palpitations, seek medical attention promptly. Remember, understanding your body and its responses is key to maintaining both physical and mental well-being.

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