What's normal for my heart

Racing heart

Brief overview

  • What is a racing heart? When the heart is racing (tachycardia), the heart beats more than 100 times per minute (adults). A distinction is made between supraventricular tachycardia (arises outside the ventricles) and ventricular tachycardia (arises in the ventricles) according to the location of its origin. 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 heart disease (CHD), high blood pressure, overactive thyroid (hyperthyroidism), shock hormone fluctuations during menopause, large blood loss, anemia, pulmonary embolism, poisoning, medication, drugs, nicotine, caffeine.
  • First aid: Alert an emergency doctor if there are additional symptoms such as shortness of breath, shortness of breath, tightness in the chest, severe chest pain, feelings of fear, unconsciousness, cardiac arrest. First aid for life-threatening ventricular fibrillation / ventricular flutter: chest compressions, use of a defibrillator or punch on the chest. Benign palpitations (palpitations) occur suddenly and usually go away on their own; Tips such as relaxation exercises, deep breathing in and out, and Valsalva maneuvers may help.
  • When to the doctor Palpitations should always be checked by a doctor!
  • Diagnosis:Medical history, physical examination, EKG, long-term EKG, 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 more than 100 beats per minute, it is called tachycardia. Pronounced tachycardia is present from 150 heartbeats per minute. The increased palpitations associated with the racing heart can be felt up into the throat!

Palpitations are not necessarily dangerous. Benign racing heart, colloquial Heart pounding called, usually occurs as a side effect of harmless disorders. One example is the so-called AV node reentry tachycardia, in which the spread of excitation between the ventricles and auricles is disturbed. Benign palpitations occur suddenly again and again and just as unexpectedly go away completely by themselves. 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 show up at rest or some time after you have exerted yourself.
  • The heart beat may be accompanied by dizziness, pressure on the chest, or nausea.

In general, if the heart is healthy, it can cope with a sudden, benign racing heart. Nevertheless, you should definitely have a doctor clarify even benign palpitations in order to rule out more serious causes and avoid problems in everyday life. Because the ability to work and drive is restricted during an attack. It can even lead to fainting.

Forms of racing heart

Depending on where the palpitations arise, a distinction is made between:

  1. Supraventricular tachycardia: This is where the palpitations develop outside the ventricles.
  2. Ventricular tachycardia: This creates the accelerated pulse in the heart chamber. this is the dangerous form of the heart race, as it can result in life-threatening ventricular fibrillation.

Heart palpitations can also acute or chronic occur.

Palpitations: causes

Physical exertion (for example during sport), stress, joy and fear can already make the pulse skyrocket. This is perfectly normal and not a cause for concern. How fast the heart normally beats also depends on age. Children usually have a higher heart rate than adults. Therefore, there is usually nothing to worry about with toddlers with a heart rate of 100 beats per minute.

It is different in adults with such a high pulse. Here it must be medically clarified what the cause is. 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 have to know how the vital muscle works: Specialized heart muscle cells generate electrical impulses (excitations). These are passed on via conduction pathways in the heart and trigger a muscle contraction - the heartbeat. The main role is played by the so-called sinus node in the right atrium of the heart with a frequency of 60 to 80 excitations per minute. If this excitation conduction system is disturbed, for example by reduced blood flow, additional conduction pathways or malfunctions of the sinus node, palpitations can occur.

The main cardiac causes of tachycardia are:

  • Atrial flutter / atrial fibrillation: Disordered electrical stimuli cause the muscles of the atria to flutter or flicker. The result is usually an accelerated, irregular pulse of more than 100 beats per minute. But that is not dangerous, many sufferers do not even notice the fluttering or flickering. However, there is an increased risk of thrombosis!
  • Coronary heart disease (CHD): This is understood to mean circulatory disorders of the heart, which are based on a narrowing of the coronary vessels as a result of arteriosclerosis. Among other things, they can lead to arrhythmias (such as tachycardia) and heart attacks.
  • Ventricular flutter / ventricular fibrillation: Here the heart chambers contract very quickly (between 200 and 800 times a minute). As a result, the blood is no longer pumped into the circulation - the consequences are unconsciousness, respiratory and circulatory arrest. There is an acute danger to life!
  • Sinus tachycardia: The sinus node works here at an accelerated rate of more than 100 excitations per minute. This type of rapid heartbeat often shows up in anxiety, panic attacks, or fever.
  • AV Nodal Reentry Tachycardia: During reentry, circular excitations spread between the ventricles and auricles and accelerate the pulse. Sudden palpitations of the heart, which go away by itself, are typical. AV nodal reentry tachycardia is not dangerous. Sometimes you can stop it yourself, for example by briefly pressing the carotid artery. But you have to have a doctor show you this beforehand!
  • Ventricular tachycardias: Additional impulses in the chambers make the heart beat faster and more inefficiently. Ventricular fibrillation can be dangerous.
  • Wolff-Parkinson-White Syndrome: Those affected have additional stimulus conduction between the atrium and ventricle from birth. This can lead to a sudden racing heart and even loss of consciousness. Often, however, those affected are symptom-free and no treatment is required.
  • High blood pressure: Not only high blood pressure, but also a fast pulse can lead to increased heart palpitations.

Other common causes of palpitations

  • Overactive thyroid gland (hyperthyroidism)
  • Hormonal fluctuations during menopause
  • Shock after injuries with great blood loss
  • Anemia (anemia)
  • Pulmonary embolism
  • Poisoning
  • Medication
  • Drugs
  • Nicotine and caffeine

Diseases with this symptom

Find out here about the diseases that can cause the symptom:

Behave correctly when your heart beats

Benign heartbeat you can stop yourself with a few techniques:

  • Take a deep breath in and out: Heart 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 located where you can feel the pulse on the neck. It records the pressure in the carotid arteries and controls the blood pressure. Massage this area lightly with your index and middle fingers. This can slow down the heartbeat. But be careful: the blood pressure usually drops a little too, which is why this technique should only be used while lying down or sitting.
  • Do the Valsalva maneuver: You hold 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: The same effect as the Valsalva maneuver is the quick drinking of a cold, preferably carbonated, drink and the subsequent belching.
  • Refrain from coffee and cigarettes: If you suffer from rapid heartbeat, you should avoid substances that increase the heartbeat and blood pressure. These are, for example, caffeine and nicotine.
  • Don't get stressed: The main cause of palpitations is and remains stress. Take it easy in everyday life and use relaxation techniques. These include, for example, progressive muscle relaxation, autogenic training or yoga.

Palpitations: When do you need to see a doctor?

Basically, you should have a recurring palpitations - even if it goes away on its own - always have a doctor examine you. Only the doctor can identify the causes and initiate appropriate treatment steps.

You should have a racing heart in the following cases call the emergency doctor immediately:

  • The tachycardia does not go away on its own, and actions such as pressure on the carotid artery do not help either.
  • Breathlessness, shortness of breath and tightness in the chest accompany the racing heart.
  • There are also severe chest pain, feelings of fear and shortness of breath.
  • It leads to unconsciousness and even cardiac arrest.

Note: With 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 on the chest can usually interrupt the rapid conduction of stimuli and initiate a new, slow heartbeat.

Palpitations: the doctor does that

The doctor will talk to you first to get important information about your Medical history to obtain (anammesis). For example, he can ask the following questions:

  • When did the palpitations occur for the first time and when was the last time?
  • Does the palpitations only occur in situations associated with stress, fear or physical exertion, for example?
  • How often do you have a racing heart?
  • Does the palpitation occur suddenly or gradually? And how does it go away?
  • How high is the pulse? Does the heart beat regularly while the heart is racing? How long does a seizure last?
  • Have you ever passed out during a seizure?
  • Can you get the tachycardia under control yourself (e.g. with a drug or your own actions)?
  • Are there any cases of palpitations in your family?
  • Do you have additional symptoms such as shortness of breath or a feeling of pressure in your chest?

This is followed by one physical examinationwhere the doctor will also listen to your heartbeat. Coming in addition further investigation methods in question, for example:

  • Electrocardiography (EKG): The heart currents are recorded, which is essential for the diagnosis. If the heart currents are changed, this can indicate various heart diseases.
  • Long-term ECG: In contrast to the snapshot of the classic EKG, the heart activity is recorded continuously for 24 hours with the long-term EKG. In this way, irregularities can be reliably identified.
  • Cardiac ultrasound (echocardiography): This examination can be done from the outside through the skin or from the inside through 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 palpitations, the doctor will initiate appropriate treatment. Some examples:

Medication often helps against seizures or prolonged palpitations. For example, so-called antiarrhythmics (agents against cardiac arrhythmias) are often prescribed for atrial fibrillation. The patient has to take this whenever the heart gets out of step. Usually he also receives anticoagulants to counter the increased risk of thrombosis (such as stroke) with atrial fibrillation. When psychological factors such as stress or fears trigger the heart racing, tranquilizers such as benzodiazepines often help.

Medication is not always enough to get a tachycardia under control. Then, depending on the cause, other therapies come into question. In the case of WPW syndrome, for example, it may be necessary to obliterate the excess conduction pathway (catheter ablation). Is that based Racing heart on a life-threatening ventricular fibrillation, one tries to end it as quickly as possible with the help of electric shocks (electrocardioversion).

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