Rapid Heartbeat: Causes, Symptoms, and Solutions

Q: Rapid Heartbeat: Causes, Symptoms, and Solutions

Hello, Ms. <br>BABY： Please schedule an appointment with a cardiologist for a 24-hour Holter monitor and thyroid function tests to determine if there is hyperthyroidism or arrhythmia, which will allow for effective treatment.

Increased heart rate?

Hello doctor, last December I went to the emergency room at a large hospital because of a rapid heartbeat.
They performed an electrocardiogram (ECG) and said everything was fine, and they also drew arterial and venous blood, which came back normal.
After that, sometimes when I do housework, my heart races, and when I climb a few flights of stairs or lift something heavy, my heart rate increases.
I am still quite young, so I didn't expect this.
On the morning of March 20, when I got up and started walking, my heart was racing, my hands and feet felt cold, and I felt like I was about to faint.
My family took me to the emergency room again, where they did another ECG and drew more blood, but again, everything was normal.
The ECG showed a slightly elevated heart rate, but every time my heart races, I feel like I'm about to faint and have difficulty breathing.
The doctor plans to check my thyroid function through blood tests.
They prescribed me two medications: propranolol and alprazolam, which have helped a bit, but after taking them, I feel dizzy.
I am planning to get pregnant, but my heart keeps racing, and I don't know what to do.
Please help me, as sometimes my heart rate increases when I feel anxious, making it even faster.

BABY, 20~29 year old female. Ask Date: 2001/03/23

Dr. Ke Zhengchang reply Internal Medicine

Hello, Ms.
BABY: Please schedule an appointment with a cardiologist for a 24-hour Holter monitor and thyroid function tests to determine if there is hyperthyroidism or arrhythmia, which will allow for effective treatment.

Reply Date: 2001/03/23

More Info

Understanding rapid heartbeat, or palpitations, can be a complex issue that involves various physiological and psychological factors. Based on your description, it seems you have experienced episodes of rapid heart rate (tachycardia), particularly during physical exertion or stressful situations. You also mentioned feeling faint and having cold extremities, which can be concerning symptoms.

Causes of Rapid Heartbeat
1. Physiological Responses: Rapid heartbeats can occur as a normal response to physical activity, stress, or anxiety. When you engage in activities like climbing stairs or lifting heavy objects, your heart rate naturally increases to supply more oxygen to your muscles. However, if this response feels exaggerated or is accompanied by symptoms like dizziness or breathlessness, it may warrant further investigation.

2. Anxiety and Stress: Emotional factors play a significant role in heart rate regulation. Anxiety can trigger the release of stress hormones like adrenaline, which can lead to an increased heart rate. Your mention of feeling more anxious during these episodes suggests that your emotional state may be influencing your heart's behavior.

3. Medical Conditions: Although your previous tests, including an electrocardiogram (ECG) and blood tests, returned normal results, certain conditions can still cause palpitations. Hyperthyroidism, for example, can lead to an increased heart rate and should be ruled out with specific thyroid function tests. Other potential causes include electrolyte imbalances, anemia, or even structural heart issues, although these seem less likely given your age and previous evaluations.

4. Medications: You mentioned being prescribed propranolol and alprazolam. Propranolol is a beta-blocker that can help manage heart rate and anxiety symptoms, while alprazolam is a benzodiazepine used for anxiety. Both medications can have side effects, including dizziness or lightheadedness, especially when starting treatment or adjusting dosages.

Symptoms to Monitor
- Dizziness or Fainting: If you experience significant dizziness or feel like you might faint, this is a critical symptom that should be communicated to your healthcare provider. It may indicate that your heart is not pumping effectively during these episodes.

- Breathing Difficulties: Shortness of breath during episodes of rapid heartbeat can also be a sign of an underlying issue that needs to be addressed.

- Cold Extremities: This can be a sign of poor circulation or a response to anxiety, but it’s worth discussing with your doctor.

Solutions and Recommendations
1. Lifestyle Modifications: Consider implementing stress-reduction techniques such as mindfulness, yoga, or regular exercise. These can help manage anxiety and improve your overall cardiovascular health. Additionally, maintaining a balanced diet and staying hydrated can support heart function.

2. Regular Monitoring: Keep a diary of your symptoms, noting when they occur, their duration, and any associated activities or stressors. This information can be invaluable for your healthcare provider in diagnosing the issue.

3. Follow-Up with Healthcare Providers: Since you are considering pregnancy, it’s crucial to have a thorough discussion with your healthcare provider about your heart health and any potential risks. They may recommend further testing or adjustments to your medication regimen to ensure your heart is stable before and during pregnancy.

4. Consider a Specialist: If symptoms persist or worsen, it may be beneficial to consult a cardiologist or an electrophysiologist, who specializes in heart rhythm disorders. They can provide more targeted assessments, including a Holter monitor or an event recorder, to capture your heart's activity over time.

In conclusion, while rapid heartbeat can be distressing, understanding the potential causes and symptoms can help you manage your condition effectively. It’s essential to maintain open communication with your healthcare providers and advocate for your health, especially as you consider starting a family.

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