Fast Heartbeat

Overview

A fast heartbeat is the sensation that the heart is racing or beating quicker than expected. It is often a normal response to exercise, emotion, pain, fever, dehydration or caffeine, and in these situations the heart is healthy. It becomes a symptom to assess when it comes on at rest, is sudden in onset and offset, is very fast, lasts a long time, or comes with chest discomfort, dizziness or breathlessness. This page covers the episodic sensation of a fast heartbeat; a persistently elevated resting heart rate found on measurement is a separate concern covered on High Resting Heart Rate.

Common causes

• Normal triggers — exercise, emotion, pain, fever, dehydration and caffeine.
• Anxiety and stress, including panic.
• Rhythm problems — supraventricular tachycardia, atrial fibrillation and other tachyarrhythmias.
• An over-active thyroid (hyperthyroidism).
• Anaemia.
• Medication effects — inhalers, decongestants and certain other medicines.
• Alcohol and recreational substances.
• Electrolyte disturbances such as low potassium.

Symptoms and associated features

The key details are how the fast beat starts and stops (sudden vs gradual), how fast it is, how long it lasts, and what accompanies it. A sudden very fast beat that stops abruptly may suggest a rhythm problem; a fast beat that builds with stress or illness is more often benign. Chest discomfort, dizziness, faintness or breathlessness with the fast beat raise the need for prompt assessment.

Evaluation and investigations

Evaluation begins with a careful history and examination, followed by an ECG. Blood tests check thyroid function, anaemia, electrolytes and blood sugar. When episodes are intermittent and the ECG is normal between them, an ambulatory ECG (Holter monitor) is used to capture the rhythm during an episode. See ECG Evaluation for Symptoms, High Resting Heart Rate and Abnormal Test Results.

Management overview

Management treats the cause. Benign triggers are managed with lifestyle measures and reassurance; rhythm problems are managed with rate or rhythm control and, where appropriate, specialist referral; an over-active thyroid is treated; anaemia is corrected; and medication-related fast beats are resolved by reviewing the prescription.

Follow-up and monitoring

Follow-up confirms the episodes have settled and any rhythm problem is controlled. Persistent or recurrent episodes are reviewed and referred for specialist cardiac assessment when appropriate.

Warning signs — seek urgent care

• A very fast heartbeat with chest pain, dizziness, fainting or breathlessness — urgent.
• Sudden fast heartbeat that does not settle — urgent.
• Fast heartbeat with collapse or loss of consciousness — emergency.

How we help

Dr. Nayak evaluates a fast heartbeat with a structured history, examination, an ECG and targeted blood tests, arranges a Holter monitor where needed, and treats the underlying cause or refers for specialist cardiac care. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Palpitations
• High Resting Heart Rate
• Irregular Heartbeat Sensation
• ECG Evaluation for Symptoms
• Thyroid Disorders
• Anaemia & Blood Problems