Tachycardia is a condition characterized by an abnormally fast heart rate, typically defined as a heart rate exceeding 100 beats per minute (bpm) in adults. It occurs when electrical signals in the heart that coordinate the heartbeat do not function properly. This can result from various factors, including stress, exercise, fever, anemia, hyperthyroidism, heart disease, and certain medications. Tachycardia can be classified into several types, including atrial, supraventricular, and ventricular tachycardia, each originating from different areas of the heart.
Clinical Evaluation
Patient History: Detailed account of symptoms, duration, frequency, and potential triggers. Review of medical history and risk factors such as heart disease, thyroid issues, and use of stimulants.
Physical Examination: Assessment of heart rate, rhythm, and overall cardiovascular function. Examination for signs of heart failure or other underlying conditions.
Diagnostic Tests
Electrocardiogram (ECG): Primary test to measure the heart's electrical activity and identify the type of tachycardia.
Holter Monitor: Continuous ECG recording over 24-48 hours to detect intermittent tachycardia.
Event Monitor: Worn for an extended period to capture episodes of tachycardia that occur sporadically.
Echocardiogram: Ultrasound of the heart to assess its structure and function.
Blood Tests: To check for conditions such as anemia, electrolyte imbalances, and thyroid function.
Stress Test: To observe heart function and rhythm during physical exertion.
Electrophysiological Study (EPS): Invasive test to map the heart's electrical pathways and identify abnormal areas causing tachycardia.
Rapid heartbeat (palpitations).
Shortness of breath.
Dizziness or lightheadedness.
Chest pain or discomfort.
Fainting (syncope).
Fatigue.
Anxiety.
In severe cases, sudden cardiac arrest.
The treatment for tachycardia depends on the type and underlying cause. Options include:
Medications: Antiarrhythmic drugs to control heart rate and rhythm. Beta-blockers and calcium channel blockers to slow the heart rate.
Vagal Maneuvers: Techniques such as bearing down or coughing to stimulate the vagus nerve and slow the heart rate.
Cardioversion: Electrical shock delivered to the heart to restore a normal rhythm in cases of persistent tachycardia.
Catheter Ablation: Minimally invasive procedure to destroy small areas of heart tissue causing abnormal electrical signals.
Pacemaker: Implantable device to regulate heart rate in cases of bradycardia-tachycardia syndrome.
Implantable Cardioverter-Defibrillator (ICD): Device implanted in patients at risk of life-threatening ventricular tachycardia or fibrillation to detect and correct abnormal rhythms.
Surgery: In rare cases, surgery may be necessary to remove a tumor or correct structural heart issues causing tachycardia.
Lifestyle Changes: Avoiding triggers such as caffeine, alcohol, and stress. Managing underlying conditions like hypertension and hyperthyroidism.
Regular Monitoring: Ongoing follow-up with a healthcare provider to monitor heart health and adjust treatment as needed.