Tachycardia

Tachycardia (心跳過快) refers to a person's heart rate exceeding 100 beats per minute when resting. Strenuous exercise, stress, anxiety, or taking certain drugs may cause physiological tachycardia; cardiovascular disease, anaemia, hyperthyroidism and other diseases can cause pathological tachycardia, increasing the risk of serious complications, and need to be assessed and managed as soon as possible . Learn the causes of a fast heartbeat and know how to deal with it.

What is the standard heart rate?

The normal heartbeat for an adult at rest is 60-100 beats per minute. You may have tachycardia if your resting heartbeat is consistently higher than 100 beats per minute or is accompanied by symptoms such as fainting, dizziness, or shortness of breath.

Causes of fast heartbeat

Anemia
Drinking too many caffeinated drinks
Drinking too much alcohol
Doing sports
Having a fever or infection
High blood pressure or low blood pressure
Electrolyte imbalance
Drug side effects
Hyperthyroidism
Smoking
Feeling suddenly stressed or frightened
Use stimulants such as cocaine or amphetamines

Types of fast heartbeat

Atrial fibrillation (AFib or AF): Atrial fibrillation is the most common fast heartbeat caused by chaotic, irregular electrical impulses in the atria and the heart's upper chambers. The beating speed of the atria can exceed 300 times per minute, causing the ventricles to beat rapidly and irregularly.

Atrial flutter (AFL): The atrium beats too fast, which in turn causes the ventricles to beat rapidly, but the rhythm is still regular to a certain extent. The heart beats as fast as 250 times, mainly driven by irregular electrical impulses from the atria (upper heart chambers).

Supraventricular tachycardia (SVT): Supraventricular tachycardia is an irregularly fast heartbeat caused by an abnormality in the heart's electrical conduction system. It is usually present at birth and produces loops of overlapping signals.

Ventricular tachycardia (VT or VTach): Extremely fast heartbeat, a warning sign of serious heart disease. A rapid heart rate prevents the ventricles from filling and contracting effectively to pump enough blood to the body, which can turn into fatal ventricular fibrillation, which requires early monitoring and treatment.

Ventricular fibrillation (VF or VFib): Rapid and chaotic heartbeat prevents the heart chambers from pumping blood and oxygen to the brain and body, causing the heart to stop completely. When the disease occurs, the heart must be stimulated with electricity immediately. Treat the condition in time, otherwise the brain will be deprived of oxygen, soon lose consciousness, and die within minutes. This is the culprit of half of sudden deaths from heart disease.

Symptoms related to a fast heartbeat

Shortness of breath
Dizziness
Rapid pulse rate
Palpitations
Irregular heartbeat or a "thumping" feeling in the chest

How to diagnose a fast heartbeat

Some patients with tachycardia have no symptoms and can only be discovered through a physical examination or heart monitoring test with an electrocardiogram. Other investigative adjuncts to a fast heartbeat are:

Continuous EKG (ECG) monitoring: A portable monitor (also known as a Holter monitor) worn on the chest continuously records the electrical impulses (EKG/ECG) for 24 to 48 hours to assist in identifying abnormal heart rhythms not detected during a resting EKG.
Electrophysiological test: A catheter is inserted into the blood vessels in the groin and extended to the heart. The tip of the catheter stimulates the heart, and the heart's electrical activity is recorded.
Cardiovascular MRI: Imaging of the heart is performed to determine whether structural abnormalities are affecting blood flow and causing fast heartbeats.
Chest X-ray: Checks the lungs. If fluid is found in the lungs, it may be related to heart failure.
Echocardiogram: Provides detailed information about the structure and function of the heart.
Blood tests: Complete blood count to rule out anaemia, renal function tests to rule out compromised kidney function and electrolyte imbalance, thyroid function tests, etc.
Stress test: also known as a Treadmill test, assess whether a fast heartbeat induced by stress or exercise is causing significant ischemia (oxygen hunger) of the heart, among other things.

What should I do if my heartbeat is too fast?

Doctors will give other treatment plans and suggestions for each person's condition. The following are common management for a fast heartbeat:

Vagus Nerve Maneuvers: Performing vagus nerve maneuvers when your heartbeat is racing, including coughing, pressing down as if you were having a bowel movement, and placing an ice pack on your face, can help lower your heartbeat.
Medications: Antiarrhythmic drugs are medications that can restore normal heart rate.
Use of an Automated External Defibrillator (AED) - in emergency situations, the use of an AED – a device that analyses the heart rhythm and delivers measured electrical shocks- can be life-saving, especially in cases of ventricular fibrillation or symptomatic tachycardias.

How to prevent fast heartbeat?

Maintain good eating habits
Do regular moderate exercises
Control blood pressure and cholesterol levels
Quit smoking and avoid taking stimulants
Limit caffeine intake
Be cautious about taking over-the-counter medicines that may cause your heart to race
Avoid excessive stress

OT&P Advice

A faster heartbeat is a normal response when you exercise strenuously, feel nervous, anxious, or take certain medications. However, if it is accompanied by symptoms such as shortness of breath, dizziness, or even palpitations, the heartbeat may be too fast or is causing significant compromise to the heart. You should seek medical advice and conduct detailed examinations as soon as possible to avoid ignoring potential diseases.

References

1. Mayo clinic. Tachycardia - Symptoms and causes. 14 Sept 2023 Retrieved from https://www.mayoclinic.org/diseases-conditions/tachycardia/symptoms-causes/syc-20355127

2. Heart Matters. What is a normal pulse rate? 14 Sept 2023 Retrieved from https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/pulse-rate

3. Cleveland Clinic. Pulse & Heart Rate. 14 Sept 2023 Retrieved from https://my.clevelandclinic.org/health/diagnostics/17402-pulse--heart-rate

4. Medical News Today. How do you lower your resting heart rate? 14 Sept 2023 Retrieved from https://www.medicalnewstoday.com/articles/321310

5. WebMD. What to Do If Your Heart Races, Slows Down, or Skips a Beat. 14 Sept 2023 Retrieved from https://www.webmd.com/heart-disease/atrial-fibrillation/what-to-do-heart-races