The term "increased heartbeat" combines a variety of complaints about unpleasant sensations in the chest, which the patients themselves can also call beats, shocks, interruptions, etc. Patients may complain of palpitations both with rhythm and conduction disorders of the heart, and with other diseases. In some cases, the heartbeat is a symptom of life-threatening arrhythmias, so with such complaints, a thorough examination is required.
Often the heartbeat is caused by emotional and physical exertion. With fever, there is also an increase in pulse. If the heartbeat is not caused by these reasons, then arrhythmia should be suspected.
The most likely cause
Increased heartbeat can be a symptom of cardiac or other pathology, occur with emotional or physical exertion.
The most frequent arrhythmias are sinus tachycardia, atrial and ventricular extrasystoles, atrial fibrillation, supraventricular tachycardia.
With sinus tachycardia, the heart rate (HR) is 100-160 per minute. The main causes of sinus tachycardia are fever, emotional and physical exertion, increased anxiety.
The most dangerous diseases
- Life-threatening arrhythmias:
- ventricular tachycardia;
- syndrome of weakness of the sinus node;
- complete atrioventricular blockade.
- Ischemic heart disease and myocardial infarction. Sometimes the heartbeat is a manifestation of myocardial infarction or unstable angina. It must be remembered that myocardial infarction can occur in a painless form, manifesting, in particular, a violation of the rhythm.
- Wolff-Parkinson's-White syndrome (WPW-syndrome).
- Electrolyte disorders:
- hypokalemia (lack of potassium in the blood);
- hypomagnesiesmia (lack of magnesium in the blood).
Diseases of other organs that cause an increased heartbeat
Arrhythmia may not be an independent disease, but a consequence of many other diseases and conditions:
- fever
With an increase in body temperature by 1 ° C, the pulse quickens by 10 beats per minute.
- pregnancy
Increased heartbeat during pregnancy is necessary for the normal blood supply to the fetus and is associated with an increase in the volume of blood in the woman's body.
- menopause
In menopause, women increase the likelihood of diseases of the heart muscle of hormonal origin (non-ischemic). They are manifested, in particular, by the heartbeat.
- use of medicines, caffeine, cocaine, energy drinks, alcohol
Drugs that can cause a violation of the rhythm of the heart include: antiarrhythmic drugs, antidepressants, many diuretics, nitrates, cardiac glycosides, vasoconstrictors for the common cold, Salbutamol, Thyroxine.
- mitral heart defects and aortic insufficiency
- hypoxia and hypercapnia
These are any conditions associated with a lack of oxygen: staying in a mountainous area, lung disease, increased carbon dioxide in the inhaled air, etc.
- pheochromocytoma
This is a rare tumor of the adrenal glands. It is characterized by orthostatic tachycardia: heart rate when changing the position of the body from horizontal to vertical increases by more than 20 beats per minute.
- tick bites in the defeat of dermatomes Th1-Th5 (upper limbs, chest)
- depression (including postpartum)
- diabetes mellitus (with hypoglycemia)
- anemia (heart palpitations are a very common sign of low hemoglobin in the blood)
- thyroid diseases (thyrotoxicosis, thyroxine overdose in hypothyroidism)
- osteochondrosis of the thoracic spine
- urinary tract infections (especially in the elderly)
- mitral valve prolapse
In middle-aged women, a heartbeat may occur in combination with pain in the heart area, not typical for angina. Very often, this combination is a sign of mitral valve prolapse. This condition is detected by ultrasound of the heart (echocardiography).
Mental disorders
The heartbeat can be both a cause and a consequence of mental disorders. If the organic and metabolic causes of arrhythmia cannot be identified, then anxiety disorders and depression are excluded.
Sometimes complaints of palpitating appear when one of the relatives or friends of the patient suffers from severe heart disease (cardiophobia).
It should also be remembered that in a patient with anxiety or depression, arrhythmia aggravates mental disorders.
Survey
An important role in the diagnosis of arrhythmias is played by anamnesis (history of the disease) and physical examination. The diagnosis is confirmed using instrumental and laboratory methods.
Anamnesis
Ask the patient to describe the attack of the heartbeat, clarify its duration, accompanying sensations. They offer to knock off the heart rhythm, as it happens during the heartbeat. If the patient finds it difficult to do this, the doctor himself knocks out the rhythms characteristic of different arrhythmias, and the patient chooses from them one that is similar to his own.
Chaotic rhythm is characteristic of atrial fibrillation. Single strong contractions after a pause against the background of the correct rhythm are a sign of extrasystole (more often ventricular). The sensation of tremors is not caused by extrasystoles, but by the heart contractions that follow them.
The main questions that a doctor can ask:
- How does the heartbeat begin and how long does it last?
- What do you think are the causes of the heartbeat?
- Is the heartbeat associated with emotional stress, excitement, anxiety?
- What sensations are accompanied by a heartbeat?
- Is it accompanied by chest pain or lack of air?
- Is the heartbeat accompanied by dizziness or fainting?
- What medications are you taking?
- How many coffees, teas, tonic drinks do you consume?
- Do you use remedies for the common cold?
- Does spicy food provoke a heartbeat?
- Do you smoke? If so, how many cigarettes a day?
- Do you use illegal drugs?
- Have you had rheumatism?
- Are you worried about weight loss or severe sweating?
Chest pain is observed with coronary artery disease and aortic stenosis, lack of air - with neuroses, mitral stenosis, heart failure. Dizziness and fainting are manifestations of aortic stenosis and severe, life-threatening cardiac conduction disorders: sinus node weakness syndrome and complete atrioventricular blockade.
Physical examination
The most informative physical (i.e. external) study conducted during an increased heartbeat, but this is not always possible. The most important stage of the examination is the study of the rhythm of heart contractions, which can be performed by the patient himself during an attack.
Heart rate above 150 per minute is characteristic of paroxysmal supraventricular tachycardia, atrial flickering or fluttering and ventricular tachycardia, below 150 per minute - for sinus tachycardia. The main causes of sinus tachycardia are physical exertion, fever, thyrotoxicosis, taking certain drugs.
Pay attention to the increased shine of the eyes, pronounced blush, neck enlargement, pulsation of the veins of the neck, increased blood pressure. Wet and warm palms may indicate in favor of thyrotoxicosis, pale - in favor of anemia.
Identify signs of heart defects, atherosclerosis of peripheral arteries.
Instrumental and laboratory studies
To diagnose arrhythmia, to distinguish one type of it from another will help electrocardiography.
Depending on the clinical picture, the doctor may prescribe the following studies:
- general blood test (hemoglobin level, leukocyte formula);
- determination of the level of thyroid hormones;
- biochemical study of blood with determination of the level of potassium and magnesium;
- serological blood tests in case of suspected viral myocarditis;
- chest X-ray;
- ECG in 12 leads;
- daily ECG monitoring;
- echocardiography;
- electrophysiological research.
Heartbeat in children
Palpisations in children can be caused by emotional and physical exertion, fever, rhythm and conduction disorders. Particular attention is required by paroxysmal supraventricular tachycardia, atrioventricular blockade and ventricular arrhythmias.
Palpity in the elderly
In the elderly, the most common causes of palpis are cardiovascular diseases (coronary heart disease, myocardial infarction, hypertension) and taking medications, especially cardiac glycosides.
Extrasystole is observed in 40% of the elderly, usually it does not require treatment.
In the elderly, sinus tachycardia or atrial fibrillation may be a manifestation (sometimes the only) of thyrotoxicosis. An additional diagnostic sign in this case is the shine of the eyes.
Principles of treatment
If you complain of an increased, rapid, irregular heartbeat, you should contact a therapist. He will conduct an initial examination, if necessary, refer to a cardiologist and other specialists.
The tactics of treatment are as follows:
- treat the underlying disease - the cause of arrhythmia;
- calm the patient, clearly explain the role of physical and emotional stress in the development of arrhythmia, treatment tasks;
- limit the use of tea, coffee, tonic drinks, alcohol;
