Rapid Heartbeat and Palpitations: When to Seek Help

Rapid heartbeat and strong heartbeats?

Hello, Doctor.
I have been experiencing symptoms of tachycardia since September of last year, but it did not affect my daily life.
By mid-October, I was experiencing persistent tachycardia (heart rate above 100 bpm) and palpitations, which forced me to stay in bed as I could not sit for long periods.
For two days, my rapid heartbeat was accompanied by shortness of breath.
By mid-November, the episodes of tachycardia became less frequent, but I still occasionally experienced rapid heartbeats daily.
From mid-November to now in January, every morning when I sit up after getting out of bed, my heart rate is above 100 bpm, and it takes a while to return to normal.
After meals, I experience tachycardia, and upon waking from a nap, my heart rate is elevated when I sit up.
Additionally, after walking for an hour outside, when I lie down at home, I feel strong palpitations and an increased heart rate, with a noticeable and uncomfortable pulse in my neck.
Sneezing causes my heart rate to spike to 130-140 bpm, which is quite distressing as I have never experienced such symptoms before.
In December, I received a vaccine, and on that day, my heart rate remained above 100 bpm, but it returned to normal the following day.
Could the symptoms described above indicate a potential heart condition or another underlying health issue?

Xiao Yin, 10~19 year old female. Ask Date: 2022/01/20

Dr. Wu Xueming reply Cardiology

Due to your young age and lack of chronic diseases, your risk of developing heart disease is low.
Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive consumption of caffeinated beverages.
It is advisable to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is still recommended to visit a hospital for an electrocardiogram (ECG) examination.

Reply Date: 2022/01/20

More Info

Understanding rapid heartbeat and palpitations can be a complex issue, especially when symptoms are persistent and affect daily life. Based on your description, it seems you have been experiencing episodes of tachycardia (heart rate over 100 beats per minute) and palpitations, which can be concerning.
Firstly, it's important to understand that palpitations can be caused by a variety of factors, including anxiety, stress, caffeine intake, dehydration, and certain medications. However, they can also indicate underlying heart conditions, especially if they are accompanied by other symptoms such as shortness of breath, chest pain, or dizziness.

Given your symptoms—persistent rapid heartbeat, difficulty sitting for long periods, and episodes of increased heart rate after meals or physical activity—it is crucial to consider a thorough evaluation. The fact that your heart rate exceeds 100 beats per minute upon waking or after exertion, and that you experience a strong pulse in your neck, suggests that your heart is working harder than normal.
In your case, the following steps are advisable:
1. Consult a Cardiologist: Since you have experienced significant changes in your heart rate and rhythm, it would be prudent to consult a cardiologist. They may recommend tests such as an electrocardiogram (ECG), echocardiogram, or Holter monitor to assess your heart's electrical activity and structure over time.

2. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their duration, and any associated activities (like eating or physical exertion). This information can be invaluable for your healthcare provider in determining the cause of your symptoms.

3. Lifestyle Modifications: Consider making lifestyle changes that may help manage your symptoms. Reducing caffeine and alcohol intake, staying hydrated, and practicing relaxation techniques such as deep breathing or meditation can be beneficial.

4. Evaluate for Anxiety: Since anxiety can exacerbate palpitations, it may be worthwhile to assess your mental health. If anxiety is a contributing factor, working with a mental health professional could help alleviate some of your symptoms.

5. Emergency Symptoms: Be vigilant for any alarming symptoms that may require immediate medical attention, such as chest pain, severe shortness of breath, fainting, or persistent dizziness. If these occur, seek emergency care.

6. Consider Other Conditions: Conditions such as hyperthyroidism, anemia, or electrolyte imbalances can also lead to increased heart rate and palpitations. Your healthcare provider may want to run blood tests to rule out these possibilities.

In conclusion, while occasional palpitations can be benign, the persistence and nature of your symptoms warrant further investigation. It is essential to work closely with your healthcare provider to determine the underlying cause and appropriate treatment plan. Early intervention can lead to better outcomes and help you manage your symptoms effectively.

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