Tachycardia

1 What is Tachycardia?

Tachycardia (tak-ih-KAHR-dee-uh) happens when there is an abnormal quickening of the electrical signals of the heart leading to a higher than normal heart rate even while at rest. In a normal healthy adult, the heart rate is 60 to 100 beats per minute when the person is in a relaxed state.

Hence, with Tachycardia the increased heart rate are in all chambers of the heart such as the upper and lower chambers since electrical signals across the heart dictates the heart rate.

There are conditions in which Tachycardia appears asymptomatic, however in severe cases there will be disruption in normal heart function leading to complications including greater risk of stroke, or cause sudden cardiac arrest or heart attack and even death.

There are available treatments to control the quickening heart rate which may prevent development of complications.

2 Symptoms

Signs and symptoms of tachycardia is related to the ineffective pumping of blood to the rest of the body arising from quickened heart rate. This results to reduced perfusion of oxygen to organs and tissues.

Signs and symptoms of tachycardia include:

Typically, individuals with tachycardia do no show symptoms in the beginning as it would normally be detectable only through physical examination or with a heart-monitoring test such as an electrocardiogram.

It is important to familiarize yourself with the signs and symptoms of tachycardia as immediate medical attention is necessary once any of these starts to manifest.

If you faint, suffer from difficulty breathing or experience chest pain for more than a few minutes then urgent medical intervention is necessary hence you would need to call 911 or your local emergency hotline.

3 Causes

Tachycardia is caused by the disruption of the normal electrical impulses that regular the heart’s normal pumping action. There are many factors that can cause impairment with the heart's electrical system, these factors include:

  • damage to heart tissues from heart disease
  • abnormal electrical pathways in the heart present at birth (congenital)
  • disease or congenital abnormality of the heart
  • anemia
  • exercise
  • sudden stress
  • such as fright
  • high blood pressure
  • smoking
  • fever
  • drinking too much alcohol
  • drinking too many caffeinated beverages
  • side effects of some medications
  • recreational drug abuse
  • such as cocaine
  • electrolyte imbalance
  • mineral-related substances necessary for conducting electrical impulses
  • overactive thyroid (hyperthyroidism)

Some conditions that cause tachycardia does not have an exact known reason for its existence. Your heart is made up of four chambers, namely two upper chambers (atria) and two lower chambers (ventricles).

The rhythm of your heart is ordinarily controlled by a natural pacemaker (the sinus node) located in the right atrium. The sinus node yields electrical impulses that stimulate each heartbeat.

From the sinus node, electrical impulses travel across the atria, triggering the atria muscles to contract and pump blood into the ventricles.

The electrical impulses then attain at a cluster of cells called the atrioventricular node (AV node), regularly the only pathway for signals to travel from the atria to the ventricles.

The AV node slows down the electrical signal before sending it to the ventricles and this slowness allows the ventricles to fill with blood.

When electrical impulses reach the muscles of the ventricles, they contract, causing them to pump blood either to the lungs or to the rest of the body.

Tachycardia occurs when there is an impairment in electrical signals that causes the heart to beat faster than normal. Common types of tachycardia include the following:

  • Atrial fibrillation. Atrial fibrillation is a swift heart rate caused by chaotic electrical impulses in the atria. These signals lead to a rapid, uncoordinated, weak contractions of the atria. The disordered electrical signals bombard the AV node, usually causing an irregular, rapid rhythm of the ventricles. Atrial fibrillation may be momentary, but some episodes won't end unless treated. Most people with atrial fibrillation have some structural abnormalities of the heart related to such conditions as heart disease or high blood pressure. Additional contributing factors to atrial fibrillation include a heart valve disorder, hyperthyroidism or heavy alcohol use.
  • Atrial flutter. In atrial flutter, the heart's atria beat very quickly but at a regular rate. The wild rate results in weak contractions of the atria. Atrial flutter is caused by irregular circuitry within the atria. The rapid signals entering the AV node cause a rapid and sometimes irregular ventricular rate. Episodes of atrial flutter may get better on their own, or the condition may persist unless treated. People who experience atrial flutter often experience atrial fibrillation at other times.
  • Supraventricular tachycardia (SVT). Supraventricular tachycardia, which initiates somewhere superior to the ventricles, is caused by abnormal circuitry in the heart, usually congenital, and produces a loop of overlying signals. In one form of SVT, an abnormality in the AV node may "split" an electrical signal into two, sending one signal to the ventricles and another back to the atria. Another common irregularity is the presence of an extra electrical pathway from the atria to the ventricles that bypasses the AV node. This may lead in a signal going down one pathway and up the other. Wolff-Parkinson-White syndrome is one disorder featuring an extra pathway.
  • Ventricular tachycardia. Ventricular tachycardia is a rapid heart rate that starts with uncharacteristic electrical signals in the ventricles. The rapid heart rate will cause the ventricles to not fill completely and contract inefficiently which result to insufficient amount of blood pump to the body. Ventricular tachycardia is usually a life-threatening medical emergency.
  • Ventricular fibrillation. Ventricular fibrillation occurs when rapid, chaotic electrical impulses cause the ventricles to quiver ineffectively instead of pumping necessary blood to the body. This serious problem is fatal if the heart isn't restored to a normal rhythm within minutes. Most people who develop ventricular fibrillation have an underlying heart disease or have experienced serious trauma, such as being struck by lightning.

4 Making a Diagnosis

Upon consultation due to a rapid heartbeat, you will be referred to a cardiologist for a more specialized diagnosis and treatment of tachycardia.

It would help if you are accompanied by a friend or family member who can offer moral support as well as help retain pertinent information discussed during the appointment. To be able to maximize the time spent with the doctor and not waste any time, here are some things to know about on how you can best prepare for your appointment.

Prepare a list of all the symptoms that you are experiencing including all those that you feel may not be related to the condition. Also, have a list of all medications that you have taken or is taking including supplements, herbs, over-the-counter drugs and vitamins including the dosage.

Key personal information may also be needed such as major cause of stress and possible life altering changes. For better management and coping with the condition, it is beneficial to understand it hence ask your doctor questions that you might find confusing or is concerned about regarding tachycardia, and such questions may be as follows:

  • What could be the reason for the rapid heart rate?
  • What tests are necessary to diagnose the condition?
  • What would be the best treatment for my condition?
  • What are the risks and possible complications of this heart condition?
  • How will we monitor the progress of the condition?
  • What is my follow-up schedule?
  • Will my other condition as well medication affect my heart problem?
  • Is there any restrictions in activity?
  • Are there available reading materials that I can take home and study?
  • What other resources would you recommend for me to better understand tachycardia?

As part of the doctor’s assessment, you will be asked questions such as:

  • When did the symptoms start?
  • When do you normally experience fast heart beat and what is the duration of the episodes?
  • Does anything, such as exercise, stress or caffeine, seem to trigger the episodes?
  • Do you smoke?
  • How much alcohol or caffeine do you consume?
  • Do you use recreational drugs?
  • Have you been diagnosed with conditions associated with high blood pressure, high cholesterol or other conditions that may affect your circulatory system?
  • If so, what treatment are you given and are you taking them as prescribed?

The doctor will conduct a physical exam, evaluate medical history and contact several heart tests to come up with a definitive diagnosis.

A primary test to diagnose tachycardia is Electrocardiogram (ECG) or electrocardiogram, this test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart, this will allow your doctor to study the patterns among these signals and detect the kind of tachycardia you have as well as other underlying hear abnormalities causing a rapid heart rate.

A portable ECG devices monitored at home may also be recommended to be able to see the heart’s electrical patterns for the past 24 hours. These devices include: Holter monitor which can easily be carried and put in your pocket or worn on a belt or shoulder strap. Also, you would need to keep a diary of your symptoms and a detailed description of each while on the monitor.

Another portable ECG device is the Event recorder which is used for an extended period of time, few weeks to a few months and will only be activated during episodes of rapid heart rate.

When you feel symptoms, you would need to push a button, and an ECG strip is generated with the captured electrical heart activity that would show your heart rhythm at the time of your symptoms.

Electrophysiological test, may be recommend to confirm the diagnosis or to isolate the location of the heart problem. During this test, a doctor inserts thin, flexible tubes (catheters) tipped with electrodes into your groin, arm or neck and navigates them through your blood vessels to different parts of your heart.

This will help determine abnormalities in your heart’s circuitry. Additional heart test may include Tilt table test, this will help your doctor to have a better grasp on how tachycardia affects the fainting spells.

Under careful monitoring while you are lying down on a table that tilts to a standing position, tachycardia episode will be triggered by administering a medication.

Changes in heart and nervous system will be observed with the changes in position.

5 Treatment

The goal of treatment for tachycardia is to hasten the rapid heart rate as well as prevent re-occurrence of the episodes and eliminate complications.

Immediate treatment of rapid heart rate may include medications or using a simple physical movement. Your doctor may teach you simple movements that can help slow a rapid heart rate during an episode and this is called Vagal maneuvers.

Such movements include: coughing, bearing down as if you are having a bowel movement and putting ice pack on your face.

Although if vagal maneuvers will not work into slowing the heart rate then medications would have to be administered in the hospital such as an injection of an antiarrhythmic medication.

Your doctor might also prescribe anti-arrhythmic drug pills such flecainide (Tambocor) or propafenone (Rythmol), which should be taken during episodes of rapid heart rate that does not respond to vagal maneuvers.

Another treatment that can be done if medications will not slow the heart rate is Cardioversion. This is an emergency procedure, in which a shock is delivered to your heart through paddles or patches on your chest which should restore normal heart rhythm.

Catheter ablation. This procedure will damage (ablate) the extra electrical pathway and prevent it from sending electrical signals which will prevent complications from tachycardia. Other medications that can be prescribed are as follows: calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others) and verapamil (Calan, Verelan, others), or beta blockers, such as metoprolol (Lopressor, Toprol) and esmolol (Brevibloc).

Pacemaker. A pacemaker is a small device that's surgically implanted under your skin. When the device senses an abnormal heartbeat, it emits an electrical pulse that helps the heart resume a normal beat. Implantable cardioverter-defibrillator. This is recommended to prevent complications from life-long episodes of tachycardia, as it detects an increase in heart rate and delivers precisely calibrated electrical shocks, if needed, to reinstate a normal heart rhythm.

Surgery. Open-heart surgery may be needed in some cases to destroy an extra electrical pathway. Surgery at times may be the last option or if medical treatment will no longer work as the goal will still be to prevent further complications or heart problems.

6 Prevention

The best way to prevent tachycardia is to decrease the risk of developing heart disease. Although in some cases such as in the case of congenital or genetic heart problems there is less or nothing that can be done to prevent this condition. However, if you already have an underlying heart illness, work closely with your doctor in monitoring your condition as well as follow your treatment plan.

To prevent further progression of the heart problems, here are some measures that you can employ:

  • Choose to live a healthy lifestyle through regular exercise and healthy food choices such as a low-fat diet that is rich in fiber from fruits, vegetables and whole grains.
  • Maintain a healthy weight, being overweight predisposes you to a number of conditions such a high blood pressure and cholesterol levels.
  • Quit smoking any form of tobacco. Also, if you are unable to stop drinking alcohol then do so moderately and less frequently.
  • Do not use recreational drugs, don’t use stimulants and cocaine. Also, decrease or eliminate your caffeine intake. Avoid stress and employ coping mechanism which will allow you to positively react to changes and stressors.
  • Attend your scheduled follow-up with the doctor, do not hesitate to tell the doctor if you are experiencing any symptoms regardless of how mild or severe it is.

7 Alternative and Homeopathic Remedies

One of the homeopathic remedies for tachycardia is Lilium Tigrinum where there is violent pulsations throughout the body with chest pain on the left side and weight in chest.

8 Lifestyle and Coping

The best way to cope with tachycardia is to understand what it is, its symptoms and the treatment options.

You would need to prepare yourself on what needs to be done should you experience an episode of tachycardia such as by doing vagal maneuvers.

Best to continuously work with your doctor or look for reliable reading materials to increase your knowledge about your condition.

9 Risks and Complications

There are several risks and complications associated with tachycardia.

There are multiple medical conditions that can put the person at a greater risk of developing tachycardia but generally any illness that causes strain in the heart or heart damage will lead to tachycardia.

Here are the factors associated with the increased risk of developing tachycardia:

  • Heart disease
  • High blood pressure
  • Smoking
  • Heavy alcohol use
  • Heavy caffeine use
  • Use of recreational drugs
  • Psychological stress or anxiety and anemia

Additional factors that puts the person at risk of tachycardia include:

  • Older age
  • Due to wear and tear
  • Family
  • Hereditary factors

Possible complications of tachycardia are the following:

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