Tachycardia symptoms: what to do and when to go to the doctor

What is a tachycardia

Tachycardia is an increased heart rate, which causes a faster-than-normal heart rate. In an adult at rest, it occurs when the heart contracts more than 100 times per minute.

How to recognize a tachycardia: symptoms

When the heart rate is very high, the heart cannot effectively pump oxygenated blood to the entire body, so other symptoms such as palpitations, the most frequent, and others that we will tell you below can occur.

Shortness of breath

Another symptom that can be associated with an episode of tachycardia is difficulty breathing normally, and the feeling that you are short of breath.

Vertigo and dizziness

It is also very common to feel dizzy or have a sensation of vertigo when a tachycardia is occurring. If you tend to get dizzy when you wake up and during the day, discover what it can be with our test.

Excessive weakness and tiredness

Another symptom of tachycardia is the feeling of abnormal weakness and fatigue, without just cause.

Chest pains

Sometimes you may feel chest pain or trembling at the same time you are having a tachycardia.

Possibility of fainting

And in extreme cases, you can even pass out (syncope) due to the lack of blood supply.

But what are the causes of tachycardia?

There are many reasons: a strong emotion, an episode of fever, exerting yourself or having taken too much coffee or toxins such as alcohol. But there can also be more serious causes.

What to do with a tachycardia?

You should try to calm down. There are many situations in daily life that can cause tachycardia. If we are afraid we can generate anxiety and fear, which in turn will aggravate the tachycardia.

When to go to the doctor?

You should see a doctor if the tachycardia persists and you do not know its origin, because it is convenient to determine the possible cause. It is especially important to go to the emergency room at your nearest health center in the event that the tachycardia is accompanied by dizziness, fainting, chest pain or shortness of breath, because you may need treatment.

What can a tachycardia hide?

Behind a tachycardia there can be from heart diseases to other ailments such as anemia, hyperthyroidism, high blood pressure … Here we tell you how to know if tachycardia can be due to a heart attack, the types of tachycardias, what treatments can be follow or how to prevent it among other information of interest.

The heart is not noticeable. He does his job in relative silence until one day he runs out of control and does it abruptly. If your heart beats faster than normal at rest, don't turn a deaf ear to it. It could be a cardiovascular disease or another serious ailment.

What is a tachycardia

Tachycardia is the increase in heart rate, which causes a faster-than-normal heart rate. In an adult at rest, it occurs when the heart contracts more than 100 times per minute. In a tachycardia, the heart can beat up to 400 times per minute.

How to recognize a tachycardia: symptoms

When the heart rate is very high, the heart cannot effectively pump oxygenated blood throughout the body, so other symptoms can occur, such as the following:

Palpitations (the most frequent).
Shortness of breath (dyspnea), with a feeling of shortness of breath.
Dizziness and vertigo
Weakness, feeling of abnormal tiredness and without just cause.
Chest pain or trembling
Fainting (syncope).

What are the causes of tachycardia?

The heart is made up of four chambers that work in a coordinated way to collect and pump blood and nutrients to the rest of the body. The cycle of contraction (systole) and relaxation (diastole) is repeated with each beat at a rate of 60 to 100 times per minute, forming the normal heart rate. A structure called the sinus node controls the proper rhythm like a natural pacemaker and is capable of speeding up or slowing the heart's contraction, causing tachycardia (fast rhythm) or bradycardia (slow rhythm).

There are many reasons that can cause a tachycardia. From a strong emotion to an episode of fever, through making a physical effort, having taken an excess of coffee or toxins such as alcohol, or some associated ailment.

Are tachycardia and arrhythmia the same?

An arrhythmia is any disturbance in the rhythm of the heart. The heart can beat too fast, which is what we call tachycardia ; too slow, that is, a bradycardia ; or it may beat irregularly. To help detect any such abnormalities, it may be helpful to check your pulse from time to time. Arrhythmia can be benign or a sign of a heart problem.

How to distinguish it from palpitations. What most of us know as palpitations - and what doctors call extrasystoles - are slight disturbances of the heart rhythm, very common, and that do not pose a threat to health. They are sensations of heartbeat that are perceived as strong and unexpected pulsations ("at the wrong time"), like a "leap in the heart". This uncomfortable sensation is usually noted in the heart, neck, or stomach region. Sometimes several beats may be felt to “disappear” or the rhythm stops for a moment and continues right after.

What to do with a tachycardia?

You should try to calm down. There are many situations in daily life that can cause tachycardia. If we are afraid we can generate anxiety and fear, which in turn will aggravate the tachycardia.

When to go to the doctor?

You should see a doctor if the tachycardia persists and you do not know its origin, because it is convenient to determine the possible cause. It is especially important to go to the emergency room at your nearest health center in the event that the tachycardia is accompanied by dizziness, fainting, chest pain or shortness of breath , because you may need treatment.

What can a tachycardia hide?

Heart disease. Heart attacks or angina, cardiomyopathies, heart failure (poor heart pumping), disturbances of the heart's electrical impulse conduction system (arrhythmias), diseases of the heart valves (valvular heart disease), congenital heart defects (atrial or ventricular communication, ductus, Fallot … ).
Other major illnesses. Anemia, hyperthyroidism, arterial hypertension, pulmonary thromboembolism (PE), pheochromocytoma, water and electrolyte alterations, infections, pulmonary diseases.

How do you know if tachycardia may be due to a heart attack?

In addition to the alteration of the heart rhythm, these seven symptoms can help you to recognize a heart attack, symptoms that in us women are not the same as in men.

Shooting pain in chest and arm. It lasts a while or it comes and goes. You can have a variety of sensations, from pain as such to uncomfortable pressure, or a feeling of being very full.
Sharp pain in the neck, back and jaw. It can be a sharp pain or a certain discomfort or fatigue - you feel as if it weighs on you - in one or both arms, back, shoulders, neck, jaw or upper part of the stomach.
Unexplained nausea or vomiting Women are twice as likely as men to suffer nausea, vomiting or indigestion when we have a heart attack.
Shortness of breath. Sometimes it is the only symptom of the heart attack. It can come on suddenly and start before or at the same time as chest pain.
Cold sweat. It comes on suddenly but is completely different from menopause.
Unusual tiredness More than half of women who have a heart attack experience muscle fatigue or weakness that are not related to exercise or other types of activity.
Unjustified stunning. Heart attacks do not usually cause someone to faint right away. Before that you usually feel lightheaded or dizzy.

If you have doubts, don't wait and go to the emergency room.

Types of tachycardia

The origin of tachycardia can be in the upper chambers of the heart, called atria (atrial tachycardia) or in the lower chambers, ventricles (ventricular tachycardia). An electrocardiogram is essential for its classification.

Supraventricular. In the atria or between the atrium and ventricle.
Sinus tachycardia It is a heart rhythm with normal characteristics (regular, well conducted), but more frequently (faster). It is the most frequent, and it is physiological (that is, it is normal). Generally, it does not require treatment except to control or eliminate the cause.
Premature atrial contractions (Atrial extrasystoles). An electrical impulse is created somewhere in the atrium that precedes that produced by the sinus node. They are perceived as a "forward heartbeat," or as a pause followed by a stronger heartbeat in the chest or throat area, although they are usually symptomless and are detected during auscultation or routine EKG. It usually occurs in healthy people, although it can sometimes be caused by disease. If it appears in healthy hearts, it is not usually treated unless it is bothersome for the person, in which case medication (beta-blockers) can be used. They differ from the rest of the alterations because they are isolated, it is not a sustained rhythm.
Atrial tachycardia. It is usually persistent, long-lasting and difficult to eliminate. It is caused by infections such as bronchitis or thyroid disorders. They are usually treated with drugs that help both to control them and to make them better tolerated.
Atrial fibrillation It is the most common sustained arrhythmia, especially in the elderly or with heart disease, but it can also occur in young people with normal hearts. It is a fast and totally irregular rhythm, which is produced by disorderly electrical activity and with multiple sources of activation. It can cause symptoms such as palpitations, shortness of breath, etc., or be totally asymptomatic. It can cause embolisms(formation of blood clots in the heart that can break loose and go through the bloodstream until they impact a blood vessel, causing lack of irrigation in that area). Its treatment involves controlling the heart rate with drugs, eliminating the arrhythmia (drugs or cardioversion), preventing new episodes (drugs or ablation) and preventing the appearance of embolisms (antiplatelet or anticoagulant). Atrial fibrillation is more serious in women, according to a study from the University of Oxford (UK). According to this research, it is the most frequent risk factor for stroke, heart failure or death in women, ahead of men.
Atrial flutter or flutter. It is similar to the previous one, but with a lower heart rate, around 150, and is caused by heart disease.
Paroxysmal supraventricular tachycardia. They are characterized by being of abrupt beginning and end, they usually give the accompanying symptoms but are well tolerated. They are common in people with normal hearts. It is the most common arrhythmia in children.
Ventricular. They are those that originate in the ventricles. They are more common in patients with heart disease and more dangerous than supraventricular.
Ventricular extrasystole. An impulse that originates somewhere in the ventricle (ectopic focus) and moves ahead of the usual rhythm, usually followed by a pause until the next normal beat (compensating pause). Although it is more common in people with heart disease, it can also occur in normal hearts. They do not produce symptoms, but sometimes this pause is perceived as annoying, in which case it can be treated with medication.
Sustained ventricular tachycardia There are rapid pulses with a frequency greater than 100 per minute, sustained for at least about 30 seconds. They usually have symptoms such as palpitations, dizziness, chest pain, and fainting. If it does not go away on its own, drug treatment or cardioversion is necessary. After having treated it, the study is continued to rule out heart disease and prevent its reappearance. If after the study it is shown that there is an increased risk of sudden death, a defibrillator can be implanted.
Ventricular fibrillation. There is so much disorganization of electrical impulses that an effective heartbeat cannot be achieved. Symptoms are an absence of pulse and sudden loss of consciousness. If it is not acted on time with electrical cardioversion and pulmonary resuscitation maneuvers it is fatal in a few minutes. It is common after an acute myocardial infarction, but if it can be treated in time, it has a very good prognosis with good long-term recovery.

What does the doctor do with a tachycardia?

The doctor will ask about possible symptoms that accompany the tachycardia, as well as a family and personal history of diseases or situations that allow the possible cause to be addressed. It is important to adequately describe the symptoms to aid the diagnosis.

The physical exam includes measuring your heart rate (the number of beats per minute), as well as your rhythm (whether it is regular or not) and blood pressure. Sometimes, counting the heart rate by palpation is difficult, so the use of machines such as the pulse oximeter - available in any emergency department - can help to diagnose it with greater precision.

By means of cardio-respiratory auscultation through the stethoscope, it can be noted if the heart is dilated (heart failure), has murmurs (valve diseases), or there are abnormal sounds in the lungs (infection, fluid …). Also the inspection of the rest of the body can help to rule out other diseases, such as thyroid (enlargement of the anterior neck area, tremors, bulging eyes …).

It is essential in all tachycardia to carry out a heart rhythm study as soon as possible, using the electrocardiogram. It continuously records the electrical activity of the heart, making it possible to detect possible arrhythmias and thus classify tachycardia, which will be very useful to establish subsequent treatment.

It should be noted that some types of tachycardia appear and disappear relatively quickly, and sometimes a single electrocardiogram can give a normal result, especially if the patient no longer notices the tachycardia. If so, the doctor can later request a 24-hour electrocardiogram recording ( Holter monitor ), using a portable device that the patient carries with him for 24 hours, thus increasing the probability of recording infrequent tachycardias.

Other scans that help the diagnosis are:

Blood test. Measures sugar, sodium, potassium, kidney function, thyroid hormones, toxins …
Echocardiogram. If there is suspicion of heart defects, as in the case of children with congenital heart disease that affects the structure of the heart.
Exercise test (Ergometry). In the event that tachycardia appears when an effort is made, as in heart attacks, angina, etc.
Other tests. In some cases, special studies called "electrophysiology" are performed , through which a catheter is inserted into the heart to collect direct information on electrical activity.

What is the treatment for tachycardia?

In the event that tachycardia is poorly tolerated (decreased consciousness, arterial hypotension, great respiratory distress, chest pain …), regardless of the cause, venous serum will be administered and the heart rate and blood pressure will be recorded continuously through monitors, administering nasal oxygen if necessary, while transferring to an emergency center for further study and specific treatment. In general, the proper treatment of tachycardia will depend on the cause that is causing it:

Anxiety Attack. Rest, anxiolytic medications (diazepan, lorazepan …).
Fever. Antipyretics (paracetamol, ibuprofen).
Infections Antibiotics will be given to fight it.
Loss of blood. Fluids will be given to compensate and the bleeding site will be located to close it.
Hyperthyroidism Medications, radioactive iodine, or surgery.
Ischemic heart disease (heart attacks, angina). Medications (aspirin, nitrates, beta-blockers …) or surgery.
Valvular diseases. Medication or in some cases surgery with replacement of the affected valve.
Cardiac arrhythmias. Depending on the type of arrhythmia, several procedures can be used.

Treatments for arrhythmias

Carotid massage. It consists of pressing for a few seconds one of the carotid arteries to slow down the acceleration of the heart rate.
Drugs. Antiarrhythmics, digoxin, beta blockers, etc.
Cardioversion. Using a defibrillator , an electric shock is applied to the heart through the chest to "resynchronize" it and return it to a normal and stable rhythm, the tachycardia disappearing.
Implantable cardioverter defibrillator. A device connected to the heart with electrodes is implanted under the skin of the shoulder to monitor the heart rhythm and deliver an electric shock in case it detects a dangerous fast rhythm.
Radiofrequency ablation. A catheter is inserted through a blood vessel into the heart and there is removed ("burned") a piece of heart tissue that interferes with normal electrical conduction.

How to prevent tachycardia

In addition to general tips like eating healthy, staying within your ideal weight, exercising regularly, or getting 7 to 8 hours of sleep, keep these tips in mind:

Keep stress at bay. Anxiety weakens the heart. When you have an episode of stress, your body releases more adrenaline and other catecholamines that can trigger an acute myocardial infarction. Find activities that help you release pressure and allow you to relax. In this article we will tell you how to overcome stress (and without meditating).
Sleep on the left side. By doing this, lymphatic drainage is easier and this makes it easier for the heart to pump. If it doesn't hurt to sleep like this, a trick not to roll over, put a pillow on your back.
Extreme dental hygiene. The Spanish Society of Cardiology and the Spanish Society of Periodontology point out that diseases that affect the gums increase the risk of suffering a heart attack. This is because bacteria in the mouth can pass into the blood.
Limit coffee. Do not drink more than 2 cups a day. In this quantity it is healthy, more quantity can test your heart.
Don't self-medicate. There are over-the-counter medications, such as some taken for colds or coughs, that can alter the rhythm of the heart. Among the medications that can lead to tachycardia are atropine, dopamine, buscopan, antiasthmatics such as salbutamol or theophylline, certain contraceptives, thyroid medications … Therefore, you should always take the drugs under medical supervision and tell them any discomfort you notice while doing it.
Give up smoking. If you still do, consider that after a year of quitting the risk of having a heart attack is 50% lower. If you have tried and you have not succeeded or if you propose it for the first time, our bedside psychologist, Rafa Santandreu will give you a cable.
Get regular checkups. If you have had episodes of tachycardia, follow up with your doctor and also try to check your pulse at home.

To know if your habits are correct and really protect you, we have a test that will help you know if you take good care of your heart.

How to control your heartbeat

How many are normal? We usually have between 60 and 80 per minute, although up to 100 is considered normal.
Where to take the pulse? In any artery that passes close to the skin, such as the carotid (at the level of the walnut) or in the wrist.
This is how it is measured. The rate is measured in beats per minute but do not count the entire minute, but rather in 10 or 15 second bands and multiply by 4 or 6.
Go to the doctor if … Your heart reaches 120 beats per minute at rest or is lower than 45. If you don't know how to calculate it, we will tell you how to take your pulse.