heart normally beats in a regular rhythm and rate that is just right for the
work your body is doing at any moment. The usual resting heart rate for adults
is between 50 to 100 beats per minute. Children have naturally higher normal
heart rates than adults.
heart is a pump made up of
four chambers : two upper chambers (atria) and two lower chambers
(ventricles). It is powered by an
electrical system that puts out pulses in a regular
rhythm. These pulses keep the heart pumping and keep blood flowing to the lungs
When the heart beats too fast, too slow, or with a
skipping (irregular) rhythm, a person is said to have an
arrhythmia. A change in the heart's rhythm may feel
like an extra-strong heartbeat (palpitation) or a fluttering in your
chest. Premature ventricular contractions (PVCs) often cause this feeling.
A heartbeat that is occasionally irregular usually is not a concern if
it does not cause other symptoms, such as dizziness,
lightheadedness, or shortness of breath. It is not
uncommon for children to have extra heartbeats. In healthy children, an extra
heartbeat is not a cause for concern.
When heart rate or rhythm changes are minor
changes in heart rate or rhythm are minor and do not require medical treatment
if you do not have other symptoms or a history of heart disease. Smoking,
drinking alcohol or caffeine, or taking other stimulants such as diet pills or
cough and cold medicines may cause your heart to beat faster or skip a beat.
Your heart rate or rhythm can change when you are under stress or having pain.
Your heart may beat faster when you have an illness or a fever. Hard physical
exercise usually increases your heart rate, which can sometimes cause changes
in your heart rhythm.
Dietary supplements, such as goldenseal,
oleander, motherwort, or ephedra (also called ma huang), may cause irregular
It is not uncommon for pregnant women to have minor
heart rate or rhythm changes. These changes usually are not a cause for concern
for women who do not have a history of heart disease.
athletes usually have slow heart rates with occasional pauses in the normal
rhythm. Evaluation is usually not needed unless other symptoms are present,
such as lightheadedness or fainting (syncope), or
there is a family history of heart problems.
When heart rate or rhythm changes are more serious
Irregular heartbeats change the amount of blood that flows to the lungs
and other parts of the body. The amount of blood that the heart pumps may be
decreased when the heart pumps too slow or too fast.
atrial fibrillation that start in the upper chambers
of the heart can be serious, because they increase your risk of forming blood
clots in your heart. This in turn can increase your risk for having a stroke or
a blood clot in your lungs (pulmonary embolism). People who have
heart failure, or a history of heart attack should be
more concerned with any changes in their usual heart rhythm or rate.
Fast heart rhythms that begin in the lower chambers of the heart are
called ventricular arrhythmias. They usually are fast and regular, such as
ventricular tachycardia, or fast and irregular, such as ventricular
fibrillation. These types of heart rhythms make it hard for the heart to
pump enough blood to the brain or the rest of the body and can be
life-threatening. Ventricular arrhythmias may be caused by heart disease such
as heart valve problems, impaired blood flow to the heart muscle (ischemia or a
heart attack), a weakened heart muscle (cardiomyopathy), or heart
Ventricular tachycardia is a life-threatening arrhythmia
that can quickly lead to ventricular fibrillation, which causes death if not
treated. Both usually cause fainting (syncope) within seconds, and you may have
symptoms of a heart attack. Emergency medical
treatment is needed, such as medicines and electrical shock
When you have a change in your heart rhythm or
rate, you also may have other symptoms, such as chest pain, shortness of
breath, lightheadedness, fainting, confusion, or weakness. Changes in your
heart rate or rhythm with other symptoms can be caused by a serious heart
Taking illegal drugs (such as stimulants, like cocaine or methamphetamine)
or misusing prescription and nonprescription
medicines can cause serious heart rhythm or rate
changes and may be life-threatening.
The U.S. Food and Drug
Administration (FDA) has banned the sale of ephedra, a stimulant sold for
weight loss and sports performance, because of concerns about safety. Ephedra
has been linked to
strokes, and some sudden deaths.
Check your symptoms to decide if and when
you should see a doctor.
Home treatment can help relieve
some problems that cause changes in your heart rate. When you think you have a
change in your heart rate or rhythm:
- Sit down and
take your pulse for 1 minute.
- If you become
lightheaded, sit or lie down to avoid injuries that
might occur if you faint and fall.
- Take a few deep breaths and try
to relax. This may slow down a racing heart rate. Be careful not to breathe too
fast, which can cause
- Cut back or eliminate
caffeine (including coffee, tea, colas, and chocolate). Some nonprescription
medicines (such as Excedrin) contain caffeine. Caffeine may increase your heart rate.
- Cut back or eliminate alcohol and
tobacco, which also contain substances that can increase your heart rate or
cause irregular rhythms.
- If your doctor has told you that you have
panic attacks, use home treatment measures to calm
You may find it helpful to keep a record of the date and time
that you noticed the change.
- What were you doing when your heart rate or
rhythm changed? Were you active or resting at the time?
- Were you
straining to urinate or have a bowel movement?
- Were you in a
stressful or fearful situation?
- Were you walking, standing,
sitting, or lying down?
- How long did the change in heart rate or
- How many times did you have
palpitations or a sense of a fast heart rate or
- Did you have any other symptoms?
what you did that helped your heart rate or rhythm to return to normal, such as
lying down, deep breathing, or coughing. Did your heart rate or rhythm return
to normal on its own?
- Try "tapping out" the heart rhythm with your
fingers and write it down so you can discuss it with your doctor.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- You continue to have changes in your heart rate
- Other symptoms develop when your heart rate or rhythm
- Your symptoms become more severe or frequent.
You often can reduce or prevent changes in
your heart rate or rhythm.
- Prevent fatigue by getting plenty of sleep and
rest. If you become overtired, your changes in heart rate or rhythm may be more
severe or occur more often.
- Cut back or eliminate caffeine,
including coffee, tea, colas, and chocolate. Some nonprescription medicines,
such as Excedrin, contain caffeine. Caffeine may increase your heart rate.
- Cut back or eliminate alcohol and tobacco,
which also contain substances that increase heart rate and can cause irregular
- Stop using medicines that increase heart rate, such as
cough and cold remedies, nose drops, or allergy relief medicines that contain
pseudoephedrine, epinephrine, or ephedrine.
- If stress affects your
heart rhythm or rate, try relaxation exercises and deep breathing techniques. A
healthy exercise program can help reduce stress. For more information, see the
Knowing CPR could be useful for anyone. Many parents learn CPR so they know what to do if their children need it. People who have family members with a heart problem also should learn CPR.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
- Do you have a history of problems with your heart
rate or rhythm? If so:
- Did you see a doctor?
- What was
- What tests were done?
- How was it
- When did you first notice the change in your heart
rate or irregular rhythm? What were you doing when it started? Were you
walking, standing, sitting, or lying down?
- Is the change in heart
rate or irregular rhythm related to activity, or does it happen when you are
- How often does the change in heart rate or irregular
rhythm occur? How long does it last?
- Is the change in heart rate or
irregular rhythm related to eating?
- What does the change in heart
rate or irregular rhythm feel like?
- Did you have other symptoms
with the change in heart rate or irregular rhythm? What were the other
- What have you tried at home to relieve the change in
heart rate or irregular rhythm?
- Do you have any
If you have kept a record of your heart rate or rhythm
changes, be sure to discuss this with your doctor.
- Anger, Hostility, and Violent Behavior
- Chest Problems
- Dizziness: Lightheadedness and Vertigo
- Weakness and Fatigue
|By: ||Healthwise Staff ||Current as of: January 14, 2014|
|Medical Review: ||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
David Messenger, MD
H. Michael O'Connor, MD - Emergency Medicine