Home Symptoms Heart palpitations (tachycardia): causes, treatment, self-help

Heart palpitations (tachycardia): causes, treatment, self-help

by Josephine Andrews
Published: Last Updated on 215 views

Typical for tachycardia (med.: tachycardia) is a rapid heartbeat with strong heart palpitations up to the throat. This is how the body reacts to fear, excitement or anticipation, for example. But heart disease can also be accompanied by tachycardia. If the heart beats more than 100 times per minute, you should definitely see a doctor. Finally, tachycardia can also lead to sudden cardiac death. Read everything you need to know about heart palpitations here.

brief overview

  • What is tachycardia? When the heart races (tachycardia), the heart beats more than 100 times per minute (adults). Depending on where it occurs, a distinction is made between supraventricular tachycardia (originates outside the heart chambers) and ventricular tachycardia (originates in the heart chambers). A distinction is also made between acute and chronic tachycardia.
  • Causes : e.g. atrial flutter / atrial fibrillation , ventricular flutter / ventricular fibrillation , sinus tachycardia, AV node reentry tachycardia, Wolff-Parkinson-White syndrome, coronary artery disease (CHD), high blood pressure , hyperthyroidism (hyperthyroidism), hormone fluctuations during menopause, shock after injuries with large blood loss, anemia ( anemia ), pulmonary embolism , poisoning, medicines, drugs, nicotine, caffeine .
  • First aid : call the emergency doctor if you have additional symptoms such as shortness of breath, shortness of breath, tightness in the chest , severe chest pain , feelings of anxiety, unconsciousness, circulatory arrest. First aid for life-threatening ventricular fibrillation/flutter: chest compressions, use of a defibrillator, or punch to the chest. Benign palpitations (palpitations) come on suddenly and usually go away on their own; Tips such as relaxation exercises, deep inhalation and exhalation, Valsalva maneuvers may help.
  • When to the doctor? Heart palpitations should always be checked out by a doctor!
  • Diagnosis: Anamnesis, physical examination, ECG , long-term ECG , if necessary cardiac ultrasound.
  • Treatment: depending on the cause, for example with medication (beta blockers) or sedatives.

Palpitations: description and symptoms

In healthy adults, the heart beats between 60 and 80 times a minute. If the heart beats faster than 100 beats per minute (tachycardia). Tachycardia is pronounced above 150 heartbeats per minute. The increased palpitations associated with the racing heart can be felt in the throat!

A racing heart is not necessarily dangerous. Benign tachycardia , colloquially called tachycardia , usually occurs as a side effect of harmless disorders. An example is the so-called AV node reentry tachycardia, in which the spread of excitation between the ventricles and atria is disturbed. Benign tachycardia always comes on suddenly and disappears on its own, just as unexpectedly. You can also recognize it by the following signs, for example:

  • The racing heart comes out of the blue, there is no recognizable connection with situations that trigger fear , excitement or anticipation.
  • The symptoms usually appear at rest or some time after physical exertion.
  • Dizziness , chest pressure, or nausea may accompany the racing heart.

In general, if the heart is healthy, it can cope well with benign tachycardia that occurs suddenly. Nevertheless, you should definitely have a benign heart palpitations examined by a doctor in order to rule out more serious causes and to avoid problems in everyday life. This is because the ability to work and drive is restricted during a seizure. It can even lead to fainting.

forms of tachycardia

Depending on where the tachycardia originates, a distinction is made:

  1. Supraventricular tachycardia : This is where the heart palpitations occur outside of the ventricles.
  2. Ventricular tachycardia : This is when the accelerated pulse develops in the ventricle of the heart. This is the dangerous form of tachycardia , as it can result in life-threatening ventricular fibrillation.

Heart palpitations can also be acute or chronic .

Heart palpitations: causes

Physical exertion (e.g. during sports), stress, joy and fear can already increase the heart rate. This is perfectly normal and nothing to worry about. How fast the heart normally beats also depends on age. Children usually have a higher heart rate than adults. That’s why you don’t usually have to worry about small children with a heart rate of 100 beats per minute.

It is different in adults with such an increased heart rate. The cause behind this must be medically clarified. It is found either in the heart itself, in another organ, or in external influences.

The heart as the cause of tarchycardia

The heart itself is primarily responsible for tachycardia. To do this, you need to know how the vital muscle works: Specialized heart muscle cells generate electrical impulses (excitations). These are passed on via pathways in the heart and trigger a muscle contraction – the heartbeat . The so-called sinus node in the right atrium of the heart plays the main role with a frequency of 60 to 80 excitations per minute. If this conduction system is disturbed, for example by reduced blood flow, additional pathways or malfunctions of the sinus node, palpitations can occur.

The main heart-related (cardiac) causes of tachycardia are:

  • Atrial flutter/atrial fibrillation : Disorderly electrical stimulation causes the muscles in the atria to flutter or fibrillate. The result is usually an accelerated, irregular pulse of more than 100 beats per minute. But this is not dangerous, many affected people do not even notice the fluttering or flickering. However, there is an increased risk of thrombosis!
  • Coronary heart disease (CHD) : This refers to circulatory disorders in the heart that are based on a narrowing of the coronary arteries as a result of arteriosclerosis . Among other things, they can lead to cardiac arrhythmia (such as tachycardia) and myocardial infarction.
  • Ventricular flutter/fibrillation: Here the ventricles contract very quickly (between 200 and 800 times per minute). As a result, the blood is no longer pumped into the circulatory system – unconsciousness, respiratory and circulatory arrest are the consequences. There is acute danger to life!
  • Sinus tachycardia: The sinus node works faster here with more than 100 excitations per minute. This form of tachycardia is often seen with anxiety, panic attacks or fever .
  • AV node reentry tachycardia: During reentry, circular excitation spreads between the ventricles and atria and accelerates the heartbeat. A sudden tachycardia, which disappears by itself, is typical. AV nodal reentrant tachycardia is not dangerous. You can sometimes stop them yourself, for example by briefly pressing on the carotid artery. But you have to have this shown to you by a doctor in advance!
  • Ventricular tachycardia: Additional impulses in the ventricles make the heart beat faster and less efficiently. Ventricular fibrillation can be a dangerous consequence.
  • Wolff-Parkinson-White syndrome: Those affected have an additional stimulus conduction between the atrium and ventricle from birth . This can lead to sudden heart palpitations and even loss of consciousness. However, those affected are often symptom-free, in which case no treatment is required.
  • High blood pressure : Not only high blood pressure, but also a fast pulse can lead to increased palpitations.

Other common heart palpitations

  • Overactive thyroid (hyperthyroidism)
  • Hormonal fluctuations during menopause
  • Shock after injuries with great loss of blood
  • anemia
  • pulmonary embolism
  • poisoning
  • medication
  • drugs
  • nicotine and caffeine

Do the right thing if you have a racing heart

You can stop benign tachycardia yourself with a few techniques:

  • Breathe in and out deeply : Palpitations are often caused by stress or anxiety. In such situations, it can help to pause for a moment, sit down and consciously breathe in and out deeply.
  • Massage your neck : The carotid sinus nerve is where you feel the pulse in your neck. It records the pressure in the carotid arteries and controls blood pressure. Massage this spot lightly with your index and middle fingers. This can slow down the heartbeat. But be careful: Usually the blood pressure also drops a little, which is why you should only use this technique while lying down or sitting.
  • Do the Valsalva Maneuver : Pinch your nose and try to exhale gently with your mouth closed. This increases the pressure in the chest and slows the heartbeat.
  • Drink first, then burp : Rapidly drinking a cold, preferably carbonated, drink and then belching has the same effect as the Valsalva maneuver .
  • Refrain from coffee and cigarettes : If you often suffer from rapid heartbeat, you should avoid substances that increase heart rate and blood pressure. Examples include caffeine and nicotine.
  • Don’t get stressed : The main cause of heart palpitations is and remains stress. Slow down in everyday life and use relaxation techniques. These include, for example, progressive muscle relaxation , autogenic training or yoga.

Heart palpitations: when do you need to see a doctor?

In principle, you should always have recurring tachycardia examined by a doctor, even if it goes away on its own . Only the doctor can identify the causes and initiate appropriate treatment steps.

In the following cases, you should call the emergency doctor immediately if your heart is racing :

  • The tachycardia does not go away on its own, and actions such as pressure on the carotid artery do not help either.
  • Shortness of breath, shortness of breath and a feeling of tightness in the chest accompany the racing heart.
  • There is also severe chest pain, anxiety and shortness of breath.
  • Unconsciousness and circulatory arrest occur.

Note: In the case of ventricular fibrillation and ventricular flutter, there is an acute danger to life! Therefore, action must be taken immediately. A strong electrical impulse from a defibrillator or a punch to the chest can usually interrupt the rapid stimulus conduction and initiate a new, slow heartbeat.

Heart palpitations: That’s what the doctor does

The doctor will first talk to you to collect important information about your medical history (anamesis). For example, he can ask the following questions:

  • When did the tachycardia first occur and when did it last?
  • Does the tachycardia only occur in situations associated with stress, fear or physical exertion, for example?
  • How often do you suffer from tachycardia?
  • Does the palpitations come on suddenly or gradually? And how does it go away?
  • How high is the pulse? Does the heart beat regularly when the heart is racing? How long does a seizure last?
  • Have you ever been unconscious during a seizure?
  • Can you get the tachycardia under control yourself (eg with medication or by your own actions)?
  • Is there a history of palpitations in your family?
  • Do you have additional symptoms such as shortness of breath or a feeling of pressure in the chest?

This is followed by a physical examination , during which the doctor will also listen to your heartbeat. In addition, other examination methods are possible, for example:

  • Electrocardiography (ECG): The cardiac currents are recorded, which is essential for diagnosis. If the cardiac currents are changed, this can indicate various heart diseases.
  • Long-term ECG : In contrast to the snapshot of the classic ECG, the heart activity is recorded continuously for 24 hours in the long-term ECG. In this way, irregularities can be reliably detected.
  • Cardiac ultrasound ( echocardiography ) : This examination can be carried out from the outside via the skin or from the inside via the esophagus . It provides information about the function and shape of the heart valves and the size of the heart.

Tachycardia: treatment

Once it is clear what is causing the tachycardia, the doctor initiates appropriate treatment. Some examples:

Medicines often help against paroxysmal or persistent tachycardia. For example, so-called antiarrhythmics (medicines against cardiac arrhythmia) are often prescribed for atrial fibrillation. The patient must always take this when the heart gets out of rhythm. He usually also receives anticoagulants to counteract the increased risk of thrombosis (such as a stroke ) associated with atrial fibrillation. If psychological factors such as stress or anxiety trigger heart palpitations, sedatives such as benzodiazepines often help.

Drugs are not always sufficient to control tachycardia. Depending on the cause, other therapies can then be considered. In the case of WPW syndrome , for example, it may be necessary to obliterate the excess excitation pathway (catheter ablation). If the racing heart is due to life-threatening ventricular fibrillation, an attempt is made to stop it as quickly as possible with the help of electric shocks (electrocardioversion).

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