Heart Rate Variations: When to Worry and When to Relax

Heart rate issues

Hello, Director.
I apologize for bothering you again, and I truly appreciate the professional knowledge you have provided me.
I understand that skipped heartbeats are not dangerous and that a fast heart rate is not necessarily a disease.
However, I still feel anxious when I experience skipped beats.
I would like to ask you about my recent heart rate, which often remains around 100 beats per minute during rest, 120-130 while walking, and only drops to 60-70 during sleep.
When I jog for 10 seconds, my heart rate reaches 150.
Is it safe for me to run? Could this prolonged elevated heart rate lead to heart problems in the future?
I understand that these heart rhythm issues are not trivial, but to feel more comfortable, should I take antiarrhythmic medication twice a day instead of the usual three times? If I take it only twice, will there be a rebound effect when the medication wears off, causing discomfort? If I take it long-term, for a month to a year, is there a chance it could help normalize my heart rate? Will tapering off the medication lead to a rebound effect?
Additionally, I would like to ask about a previous incident where my heart rate reached 170 during a panic attack, and it went up to 165 during an argument with my family, but both instances lasted only a few seconds.
Can excitement trigger paroxysmal supraventricular tachycardia (PSVT)? Although you and I believe it was caused by excitement or panic, could these feelings actually lead to PSVT? If it truly is paroxysmal atrial tachycardia (PAT), is there a risk for young people?
Thank you for your guidance, Director.
I apologize for the lengthy questions, and I wish you safety and well-being!

Nìmíng, 20~29 year old female. Ask Date: 2023/06/04

Dr. He Dongjin reply Cardiology

Hello, the effect of antiarrhythmic medication is short, so it can be taken twice or three times a day depending on how comfortable you feel.
It is unlikely to cause addiction or habitual use.
The chances of long-term correction of heart rate are low; if the heart rate is normal and fast, correction may not be necessary.
PSVT (Paroxysmal Supraventricular Tachycardia) and normal tachycardia have different mechanisms.
The likelihood of PSVT being triggered by panic is low, and PSVT in young individuals does not pose a life-threatening risk.
Don't overthink it.
Take care from Changhua Hospital.

Reply Date: 2023/06/04

More Info

Understanding heart rate variations can be quite complex, especially when considering individual circumstances such as anxiety, physical fitness, and underlying health conditions. Based on your description, it seems you are experiencing a range of heart rates that fluctuate significantly depending on your activity level and emotional state.
Firstly, it’s essential to understand what constitutes a normal heart rate. For most adults, a resting heart rate between 60 to 100 beats per minute (BPM) is considered normal. However, athletes or individuals who are physically fit may have resting heart rates lower than 60 BPM. Your resting heart rate of around 100 BPM during periods of rest is elevated and could be indicative of a condition known as tachycardia, which is defined as a resting heart rate above 100 BPM.
When you mention that your heart rate increases to 120-130 BPM while walking and can reach 150 BPM during a brief jog, this is also on the higher side. While it is normal for heart rates to increase with physical activity, the degree of increase can vary based on individual fitness levels and cardiovascular health. If you are not experiencing any symptoms such as chest pain, dizziness, or shortness of breath, it may not be an immediate cause for concern. However, it is crucial to monitor these changes, especially if they are accompanied by discomfort or anxiety.

Regarding your concerns about medication, specifically the heart rhythm medication you mentioned, it is essential to follow your healthcare provider's instructions regarding dosage. If your doctor has prescribed the medication to be taken three times a day, taking it only twice may lead to fluctuations in your heart rate, potentially causing rebound effects when the medication's effectiveness diminishes. It is advisable to discuss any changes in your medication regimen with your healthcare provider to ensure that you are managing your heart rate effectively without risking adverse effects.

As for the episodes of panic or heightened heart rates during emotional distress, such as arguments or anxiety, these can indeed lead to temporary increases in heart rate, sometimes reaching levels associated with paroxysmal supraventricular tachycardia (PSVT). PSVT is characterized by episodes of rapid heart rate that can occur due to stress, anxiety, or other triggers. While PSVT can be alarming, it is often not dangerous in young individuals unless there are underlying heart conditions. However, if you experience these episodes frequently or they are accompanied by other symptoms, it would be wise to consult a cardiologist for further evaluation.

In terms of long-term heart health, consistently elevated heart rates can lead to increased strain on the heart over time, potentially contributing to cardiovascular issues. Therefore, it is essential to adopt lifestyle changes that promote heart health, such as regular exercise, a balanced diet, and stress management techniques. Engaging in activities that help reduce anxiety, such as mindfulness or yoga, can also be beneficial.

In conclusion, while your heart rate variations may not be immediately dangerous, they warrant careful monitoring and possibly further evaluation by a healthcare professional. It is crucial to maintain open communication with your doctor regarding your symptoms, medication, and any lifestyle changes you are considering. By doing so, you can work together to develop a plan that addresses your concerns and promotes your overall cardiovascular health.

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