HEARTBEAT, RAPID

General Information

DEFINITION--Heartbeat that is much more rapid than usual and is not caused by overexertion. Tachycardia ranges from 150 to 300 beats per minute. A person with no heart disease may exercise and raise the heartbeat to 160 or more. This is normal and is not a medical problem. Types of tachycardia include atrial fibrillation, sinus tachycardia, supraventricular tachycardia and ventricular tachycardia.

BODY PARTS INVOLVED--Heart muscle; electrical system of the heart.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Heart pounding or palpitations. The pulse at the wrist or neck will be 100 to 180 beats per minute, which is much faster than normal.
• Faintness or a feeling of impending death.
• Chest pain.
• Involuntary cough.
• Breathlessness.

CAUSES--Unknown. This usually occurs in young persons with no evidence of disease, but it may also occur in older patients who have coronary-artery disease.

RISK INCREASES WITH

• Heart disease.
• Fever.
• Hyperthyroidism.
• Stress; anxiety.
• Smoking.
• Use of some drugs, such as caffeine, cocaine, ephedrine or other sympathomimetic drugs.

HOW TO PREVENT

• Don't smoke.
• Reduce stress, if possible (see How to Cope with Stress in Appendix).
• Avoid decongestants, appetite suppressants, excessive coffee, cola and other stimulants with or without caffeine, cocaine, amphetamines.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• ECG (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Self-care after diagnosis.
• Hospitalization if the attack persists, despite treatment.
• DC electrocardioversion, a controlled electric shock (rarely necessary).

POSSIBLE COMPLICATIONS--Uninterrupted tachycardia can lead to life-threatening congestive heart failure, heart attack or cardiac arrest.

PROBABLE OUTCOME--Most arrhythmias are temporary and benign. Rapid heartbeat can usually be controlled with treatment.

How To Treat

GENERAL MEASURES--

• The following sometimes reduce heartbeat: Hold your breath briefly. Pinch the skin on your arm enough to cause pain. Bathe your face in cold water, submerge your head briefly in a sink of cool water or take a cool shower and let the water beat on your head. Hold your nostrils closed and blow gently through the nose, making the eardrums pop. Massage the carotid area in the neck, if you have been taught to do this safely. Ask your doctor for instructions.
• See Resources for Additional Information.

MEDICATION--For repeated attacks, your doctor may prescribe medication to control heart rhythm. These include: digitalis; quinidine; calcium-channel blockers; procainamide; and beta-adrenergic blockers.

ACTIVITY--

• Lie down during an attack until your heartbeat returns to normal, then resume your activities.
• Exercise regularly with your doctor's approval. Physical fitness helps prevent tachycardia.

DIET--No special diet.

Call Your Doctor If

• You have an episode of rapid, irregular heartbeat that does not end in 4 or 5 minutes.
• You develop shortness of breath.
• You have chest pain.