Tachycardia – Diagnosis and Treatment
Diagnosis
When you notice symptoms like chest pain, palpitations, dizziness, fainting, feeling lightheaded, or shortness of breath, your doctor will order tests to figure out if you have tachycardia or another fast heart rhythm.
These tests help your care team pinpoint the exact type and cause of the abnormal heartbeat.
Getting the right diagnosis matters because it shapes the treatment plan. Ventricular tachycardia (VT), atrial fibrillation (AF), and supraventricular tachycardia (SVT) each need different approaches.
Key tests and devices for diagnosing a fast or irregular heart rate include:
| Test Name | What It Does | Primary Use |
|---|---|---|
| Electrocardiogram (ECG/EKG) | Records the heart’s electrical activity with sticky pads | Finds abnormal heart rhythm, type of arrhythmia |
| Holter monitor | Worn to record the heart’s activity for 24+ hours | Detects arrhythmias missed by a single ECG |
| Event recorder | Worn for weeks, records activity during symptoms | Catches less frequent heart rhythm changes |
| Echocardiogram | Uses sound waves to create heart images | Shows blood flow, checks heart function |
| Chest X-ray | Takes pictures of the heart and lungs | Checks heart size, looks for heart failure |
| Cardiac MRI | Takes detailed images using magnets and radio waves | Finds problems in heart structure, especially with ventricular tachycardia (VT) or ventricular fibrillation (VF) |
| Cardiac CT | Takes many X-ray pictures to view the heart in detail | Finds structural causes for tachycardia |
| Coronary angiogram | Uses dye and X-rays to view heart arteries | Checks for blocked or narrowed arteries, especially in VT/VF |
| Electrophysiology (EP) Study | Measures electrical signals inside the heart with small wires | Finds the source of abnormal heart rhythms, maps the heart’s circuits |
| Stress test | Checks heart function during exercise or medicine-induced stress | Reveals exercise-triggered symptoms or arrhythmias |
| Tilt table test | Measures response of heart rate and blood pressure to position change | Tests for fainting and heart rhythm response |
Electrocardiogram (ECG or EKG)
Your doctor usually starts with an ECG. They’ll stick small electrodes to your chest, arms, or legs. The test is quick and painless.
It records how fast or slow your heart beats. Smartwatches or personal devices sometimes give ECG readings, but a clinic ECG is more accurate.
Holter Monitor
You wear this device at home for 24 to 48 hours. It tracks your heart rhythm while you go about your day. The Holter monitor can catch abnormal rhythms like SVT, VT, and atrial flutter, or atrial fibrillation that don’t show up in the office.
Event Recorder
If your symptoms don’t happen often, the doctor might give you an event recorder to wear for up to a month. You press a button when you notice symptoms.
Sometimes, the device records automatically when it senses an abnormal rhythm. This helps diagnose rate arrhythmias, like paroxysmal SVT.
Echocardiogram
The echocardiogram uses ultrasound to look at your heart’s structure. It shows how blood moves through the heart and can spot problems like heart disease, heart failure, or hypertrophic cardiomyopathy.
Electrophysiological (EP) Study
If other tests don’t explain your symptoms, your doctor might suggest an EP study. They thread thin wires through a blood vessel into the heart.
These wires measure electrical signals and help pinpoint circuits or abnormal spots causing tachycardia, like atrioventricular nodal reentrant tachycardia (AVNRT) or atrioventricular reentrant tachycardia (AVRT).
Stress Test
You’ll exercise on a treadmill or bike, or sometimes get medicine to make your heart work harder. The team records your heart rate, rhythm, and sometimes takes images.
This test can reveal arrhythmias triggered by activity and may help diagnose coronary artery disease or symptoms of SVT.
Tilt Table Test
The tilt table test checks if changing positions causes fainting or dizziness. They measure your heart rate and blood pressure as the table tilts you from lying down to nearly standing. It can spot connections between rapid heart rate and fainting.
Coronary Angiogram
If your doctor suspects blocked arteries, they may order a coronary angiogram. Dye is injected into the arteries to see if blood flow is slowed, which can trigger arrhythmias like Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF).
Other Imaging Tests
Cardiac MRI and CT scans give detailed pictures of your heart’s structure. Not everyone needs these, but they can help find causes of serious arrhythmias like ventricular fibrillation or damage from a heart attack.
Doctors might also order blood tests to rule out things like thyroid problems or electrolyte imbalances that can cause tachycardia. The choice of tests depends on your symptoms, health history, exam, and the kind of abnormal rhythm suspected.
Treatment
Methods to Slow Down a Rapid Heartbeat
When your heart races, certain steps can help slow things down. Sometimes, the episode stops on its own. Other times, you’ll need to take action or get treatment if your heart keeps beating too fast.
Table: Strategies Used to Slow a Rapid Heartbeat
| Method | Description |
|---|---|
| Vagal Maneuvers | Actions like coughing, bearing down, or placing an ice pack on the face activate the vagus nerve and can slow the heart. |
| Medications | Drugs such as beta-blockers, calcium channel blockers, or antiarrhythmic medicines may be given to restore normal rhythm. |
| Electrical Cardioversion | Patches or paddles are used to send controlled electric shocks to reset the heart rhythm, often used in emergencies. |
Vagal maneuvers use simple actions to try to reset your heart. You might cough hard, bear down like having a bowel movement, or hold your breath. Sometimes, people use a cold pack on the face.
These tricks stimulate nerves that help slow the heart.
If those don’t work, your doctor may give you medication through an IV or as a pill. Medicines like antiarrhythmic drugs can stop some rapid rhythms fast.
Beta-blockers or calcium channel blockers also help slow down the heart’s conduction and control the rate.
If neither medicines nor simple maneuvers work, you might need electrical cardioversion. In this hospital procedure, the team delivers a controlled electric shock through patches or paddles on your chest to reset the heart rhythm.
Doctors usually do this when you’re feeling unwell because of a fast heartbeat.
Steps to Lower the Chance of Future Fast Heartbeats
To prevent future episodes, your doctor will look at the cause and type of tachycardia. The goal is to stop episodes from coming back and keep your heart rhythm steady long-term.
List: Preventive Approaches to Tachycardia
- Take medicines like beta-blockers, calcium channel blockers, or antiarrhythmic agents as prescribed.
- Catheter ablation uses flexible wires to destroy tiny areas of heart tissue sending abnormal signals.
- Pacemaker placement helps keep your heart beating at a steady, normal rate.
- Implantable cardioverter-defibrillator (ICD) watches for dangerous heart rhythms and delivers a shock if needed.
- Maze procedure creates a pattern of scar tissue in the upper heart chambers to block faulty signals.
- Sometimes, other surgical options are considered, especially if other treatments haven’t worked or if you’re already having heart surgery.
In some cases, treating a related health issue—like a thyroid disorder—can lower your risk of another fast heartbeat.
Your doctor may also suggest avoiding triggers like too much caffeine, alcohol, or not getting enough sleep, since these can sometimes set off rapid rhythms.
Doctors will recommend one or more of these steps based on your overall health and the type of tachycardia you have. The aim is always to keep your heart in a healthy rhythm and cut down on future episodes.
Lifestyle and home remedies
Living with tachycardia means making a few daily choices. Try to:
- Eat a heart-healthy diet with lots of fruits and veggies
- Exercise regularly—even a simple plan helps
- Avoid smoking and tobacco
- Limit caffeine and alcohol
- Getting enough sleep
Small lifestyle changes can help prevent heart rhythm problems and keep your heart healthier.
Natural Approaches
Meditation and yoga might help manage tachycardia by slowing your heartbeat. These stress-busting habits support overall heart health.
Support Strategies and Managing Symptoms
Feeling ready when your heart races can lower stress and anxiety. It helps to know how to check your pulse and what your target heart rates are. Ask your doctor when it’s safe to use vagal maneuvers.
If you notice fever, trouble breathing, or other serious symptoms, get medical help right away.
Tips for Support:
| Symptom | What to Do |
|---|---|
| Anxiety | Practice calm breathing; follow your action plan. |
| Fever | Monitor temperature; report to your care team. |
| Lung problems | Watch for shortness of breath; get help if needed. |
Getting Ready for Your Visit
Steps You Can Take Before Your Checkup
Start by gathering the important info before your heart appointment. Write down all symptoms you’ve noticed, even the ones that don’t seem heart-related.
It helps to note any major life changes or stress, since these can affect your heart. Bring a complete list of all medications, supplements, and vitamins you take, including doses and how often. This lets your care team spot possible interactions.
List of Helpful Topics and Materials:
| Category | Details Needed |
|---|---|
| Symptoms | All current and past symptoms, even if minor |
| Personal Info | Stresses, recent major changes, family history |
| Medications | Exact names, dosages, frequency, over-the-counter or prescription |
| Questions for the Doctor | Anything unclear or concerning about your condition |
Jot down questions for your doctor, like:
- What could be causing my fast heartbeat?
- Which tests do you recommend?
- What treatments are available?
- What side effects or risks should I watch for?
- How will we keep track of my condition?
- Are there any activities I should avoid?
Bringing a notepad or your phone to take notes can be a lifesaver. Some people also bring a friend or family member for support and to help remember what the doctor says.
Questions Your Doctor Might Ask You
Doctors want to get a better sense of what you’re dealing with. They might ask questions like:
- When did your symptoms start?
- How often do you feel your heart racing?
- How long does each episode last?
- Does exercise, stress, or caffeine seem to make it worse?
- Has anyone in your family had heart issues, irregular rhythms, or sudden death?
- Do you smoke now, or have you ever smoked?
- How much alcohol or caffeine do you usually have?
- What medicines are you taking at the moment?
- Are you getting treatment for high blood pressure or high cholesterol?
If you come prepared with answers, your visit will probably go more smoothly. You’ll have extra time to talk about what really matters to you. Being open and honest helps you get the most out of your appointment.
