Rapid Heartbeat: Causes, Symptoms, and Diagnosis

Rapid heartbeat

Hello, doctor! I have previously experienced occasional episodes of tachycardia with a heart rate over 100 bpm.
I underwent a 24-hour Holter monitor test, which indicated that my heart rate was within normal limits.
However, this past year, the frequency of my rapid heartbeats has increased significantly (around 100-120 bpm) and can last for several hours, sometimes accompanied by shortness of breath.
I later had an echocardiogram and another ECG, both of which were normal, and I was advised that medication was not necessary.
However, during episodes of sudden tachycardia, my clinic doctor prescribed beta-blockers to help regulate my heart rate.
If I want to further investigate, should I have blood tests to check my thyroid function? Is there a connection between tachycardia and asthma? Can tachycardia lead to any diseases? Is it more accurate to perform an ECG when symptoms are present? Thank you!

Xiao Ting, 10~19 year old female. Ask Date: 2022/09/20

Dr. He Dongjin reply Cardiology

Hello, a heart rate of around 100 to 120 beats per minute is generally considered a normal variant of tachycardia and is unlikely to cause any diseases.
If there are symptoms, an electrocardiogram (ECG) would provide a more accurate assessment.
Blood tests to evaluate thyroid function can also be performed.
An increased heart rate may be related to asthma.
If symptoms persist, it is advisable to visit a cardiology clinic for further evaluation.
Changhua Hospital cares about your well-being.

Reply Date: 2022/09/20

More Info

Understanding rapid heartbeat, or tachycardia, is crucial for identifying potential underlying health issues. Tachycardia is defined as a heart rate exceeding 100 beats per minute. It can be caused by a variety of factors, including physiological responses, emotional stress, and underlying medical conditions.
In your case, it seems that you have experienced episodes of rapid heartbeat (100-120 bpm) that last for several hours, accompanied by shortness of breath. While your previous tests, including a 24-hour Holter monitor and echocardiogram, returned normal results, it is important to consider that tachycardia can be multifactorial.
Common causes of tachycardia include:
1. Physiological Factors: Exercise, anxiety, and stress can lead to temporary increases in heart rate. Caffeine and certain medications can also stimulate the heart.

2. Medical Conditions: Conditions such as hyperthyroidism (overactive thyroid), anemia, and infections can cause an elevated heart rate. It’s wise to check thyroid function through blood tests, as hyperthyroidism can lead to symptoms like rapid heartbeat and shortness of breath.

3. Cardiac Issues: While your echocardiogram and ECG results were normal, it’s essential to rule out any potential arrhythmias or structural heart issues. Conditions like atrial fibrillation or supraventricular tachycardia can cause episodes of rapid heartbeat.

4. Autonomic Nervous System Dysfunction: Dysregulation of the autonomic nervous system can lead to symptoms like palpitations and shortness of breath. This is often seen in conditions like panic disorder or generalized anxiety disorder.

5. Lifestyle Factors: Poor sleep, excessive caffeine intake, and dehydration can contribute to episodes of tachycardia.
Regarding your question about the relationship between rapid heartbeat and asthma, it is possible for anxiety or panic attacks, which can accompany asthma, to lead to an increased heart rate. Additionally, if you are experiencing shortness of breath, it may be related to either a respiratory issue or anxiety, both of which can exacerbate each other.

As for the accuracy of an ECG, it is indeed more effective when symptoms are present. An ECG captures the heart's electrical activity at a specific moment, so if you are experiencing tachycardia during the test, it can provide valuable information about your heart's rhythm and any potential abnormalities.

In summary, while your previous tests have shown no significant issues, the persistence of your symptoms warrants further investigation. It would be beneficial to follow up with your healthcare provider regarding the thyroid function tests and to discuss the possibility of a referral to a cardiologist for more specialized testing, such as an electrophysiology study if necessary. Additionally, monitoring your lifestyle factors, managing stress, and ensuring adequate hydration can also help in managing your symptoms.
If your symptoms worsen or you experience new symptoms such as chest pain, severe shortness of breath, or fainting, seek immediate medical attention. Understanding the underlying cause of your tachycardia is essential for appropriate management and to alleviate your concerns about potential heart disease.

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