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 about 60 to 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 oleander or lily of the valley, 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. 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 stimulant drugs (such as cocaine or methamphetamine) or misusing prescription and over-the-counter 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.

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 energy drinks). Some over-the-counter medicines (such as Excedrin) contain caffeine. Caffeine may increase your heart rate or cause palpitations.
• 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.

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