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Change in Heartbeat

Overview

Your heart normally beats in a regular rhythm and rate that's just right for the work your body is doing at any moment. The usual resting heart rate for adults is between 50 and 100 beats per minute. Children have naturally higher normal heart rates than adults.

The heart is a pump made up of four chambers. The two upper chambers are called the atria. The two lower chambers are called the ventricles. The heart is powered by an electrical system that puts out pulses in a regular rhythm. These pulses keep the heart pumping and keep blood flowing to the lungs and body.

When the heart beats too fast, too slow, or with a skipping (irregular) rhythm, that's called an arrhythmia. A change in the heart's rhythm may feel like an extra-strong heartbeat (palpitation). Or it may feel like a fluttering in your chest. Premature ventricular contractions (PVCs) often cause this feeling. PVCs are heartbeats that happen sooner than they should.

A heartbeat that's irregular now and then usually isn't a concern if it doesn't cause other symptoms, such as dizziness, lightheadedness, or shortness of breath. It's not uncommon for children to have extra heartbeats. In healthy children, an extra heartbeat isn't a cause for concern.

When heart rate or rhythm changes are minor

Many changes in heart rate or rhythm are minor. They don't need medical treatment if you don't have other symptoms or a history of heart disease. Smoking, drinking alcohol or caffeine, or taking other stimulants such as diet pills or cough and cold medicines may cause your heart to beat faster or skip a beat. Your heart rate or rhythm can change when you are under stress or having pain. Your heart may beat faster when you have an illness or a fever. Hard physical exercise usually speeds up your heart rate. This can sometimes cause changes in your heart rhythm.

Dietary supplements, such as goldenseal, oleander, motherwort, or ephedra (also called ma huang), may cause irregular heartbeats.

Sometimes pregnant women have minor heart rate or rhythm changes. These changes usually aren't a cause for concern for women who don't have a history of heart disease.

Well-trained athletes usually have slow heart rates with pauses in the normal rhythm now and then. This usually doesn't need to be checked unless the person has other symptoms. These symptoms include lightheadedness and fainting (syncope). The person should also be checked if there's a family history of heart problems.

When heart rate or rhythm changes are more serious

Irregular heartbeats change the amount of blood that flows to the lungs and other parts of the body. The amount of blood that the heart pumps may be decreased when the heart pumps too slow or too fast.

Changes such as atrial fibrillation that start in the upper chambers of the heart can be serious. That's because they increase your risk of forming blood clots in your heart. This in turn can increase your risk for having a stroke or a blood clot in your lungs (pulmonary embolism). People who have heart disease, heart failure, or a history of heart attack should be more concerned with any changes in their usual heart rhythm or rate.

Fast heart rhythms that start in the lower chambers of the heart are called ventricular arrhythmias. They include ventricular tachycardia and ventricular fibrillation. These types of heart rhythms make it hard for the heart to pump enough blood to the brain or the rest of the body. They can be life-threatening. Ventricular arrhythmias may be caused by heart disease such as heart valve problems, impaired blood flow to the heart muscle (ischemia or a heart attack), a weakened heart muscle (cardiomyopathy), or heart failure.

Symptoms of ventricular tachycardia include palpitations, feeling dizzy or lightheaded, shortness of breath, chest pain or pressure, and fainting or near-fainting. Ventricular fibrillation may cause fainting within seconds. It can cause death if not treated. Emergency medical treatment may include medicines and electrical shock (defibrillation).

Taking illegal drugs (such as stimulants, like cocaine or methamphetamine) or misusing prescription and nonprescription medicines can cause serious heart rhythm or rate changes and may be life-threatening. These medicines include medicines for asthma and colds and some medicines for heart problems.

The U.S. Food and Drug Administration (FDA) has banned the sale of ephedra, a stimulant sold for weight loss and sports performance, because of concerns about safety. Ephedra has been linked to heart attacks, strokes, and some sudden deaths.

Check Your Symptoms

Do you have a concern about your heartbeat or heart rhythm?
Yes
Concern about heartbeat or heart rhythm
No
Concern about heartbeat or heart rhythm
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Did you pass out completely (lose consciousness)?
Yes
Lost consciousness
No
Lost consciousness
If you are answering for someone else: Is the person unconscious now?
(If you are answering this question for yourself, say no.)
Yes
Unconscious now
No
Unconscious now
Are you back to your normal level of alertness?
After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.
Yes
Has returned to normal after loss of consciousness
No
Has returned to normal after loss of consciousness
Did the loss of consciousness occur during the past 24 hours?
Yes
Loss of consciousness in past 24 hours
No
Loss of consciousness in past 24 hours
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Could you be having symptoms of a heart attack?
If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Yes
Arrhythmia or change in heart rate
No
Arrhythmia or change in heart rate
Was the change sudden?
Yes
Sudden change in heart rate or rhythm
No
Sudden change in heart rate or rhythm
Does your heartbeat return to normal when you lie down?
Yes
Heartbeat returns to normal after lying down
No
Heartbeat does not return to normal after lying down
Do you have other symptoms such as feeling nauseated, lightheaded or faint, or extremely tired for no reason?
Yes
Other symptoms such as nausea, lightheadedness, fainting, or severe fatigue
No
Other symptoms such as nausea, lightheadedness, fainting, or severe fatigue
Do you have a fast heart rate (more than 120 beats per minute) for no clear reason?
Many heart rate changes are minor and have an obvious cause.
Yes
Heart rate more than 120
No
Heart rate more than 120
Do you have a slow heart rate (less than 50 beats per minute) that is not normal for you?
A slow heart rate is normal for some people, especially endurance athletes. What you are looking for is a change in your usual heart rate.
Yes
Heart rate less than 50
No
Heart rate less than 50
Do you have an irregular heart rhythm that is new to you?
Yes
New irregular heart rhythm
No
New irregular heart rhythm
Do you have a history of heart problems, such as coronary artery disease, heart failure, high blood pressure, or heart rhythm problems like atrial fibrillation?
Yes
History of heart problems
No
History of heart problems
Do you feel lightheaded or dizzy, like you are going to faint?
It's normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.
Yes
Feels faint
No
Feels faint
Do you get short of breath during physical activity and have trouble getting your heartbeat and breathing under control?
It's normal to feel out of breath and have your heart rate speed up when you are exercising hard. But your breathing and heart rate should return to normal soon after you slow down or stop.
Yes
Fast heart rate and shortness of breath during physical activity
No
Fast heart rate and shortness of breath during physical activity
Do you think that a medicine or drug may be causing the change in your heart rate or rhythm?
Think about whether the heartbeat changes started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing heartbeat changes
No
Medicine may be causing heartbeat changes
Have you been noticing changes in your heartbeat for more than a week?
Yes
Heartbeat changes for more than 1 week
No
Heartbeat changes for more than 1 week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Heartbeat changes can include:

  • A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 50 beats per minute (unless that is normal for you).
  • A heart rate that does not have a steady pattern.
  • Skipped beats.
  • Extra beats.

Many things can make the heart beat faster or slower than usual. Some common examples are:

  • Stress.
  • Pain.
  • Illness or fever.
  • Dehydration.
  • Exercise.
  • Panic attacks.
  • Stimulants, such as caffeine and nicotine.
  • Medicine side effects.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is breathing so hard.
  • The child's nostrils are flaring and the belly is moving in and out with every breath.
  • The child seems to be tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than usual.
  • The child has to take breaks from eating or talking to breathe.
  • The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

Many medicines and drugs can affect the rate and rhythm of the heart. A few examples are:

  • Asthma medicines.
  • Decongestants and cold medicines.
  • Illegal drugs such as cocaine or amphetamines.
  • Some heart and blood pressure medicines.
  • Some medicines for depression and anxiety.
  • Thyroid medicine.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Self-Care

Many changes in heart rate or rhythm are minor and don't need medical treatment if you don't have other symptoms or a history of heart disease. To help you manage minor symptoms, you can cut back or stop using:

  • Caffeine (such as coffee, tea, colas, and chocolate). Some nonprescription medicines (such as Excedrin) contain caffeine. Caffeine may increase your heart rate.
  • Alcohol and tobacco. They contain substances that can increase your heart rate or cause irregular rhythms.
  • Certain medicines, such as decongestants.

It can be helpful to track your symptoms by keeping a diary. When you have a change in your heartbeat, write down what your symptoms feel like, how fast your heart is beating (how many beats per minute), and what you are doing when it happens.

Sometimes symptoms are caused by stress or by things like panic attacks. If you think this is the case, talk to your doctor.

If your symptoms come back again, it's important to see your doctor. And if your symptoms are getting worse, get medical care right away.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • Continued changes in heart rate or rhythm.
  • New or worse lightheadedness.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Credits

Current as of: January 10, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine