FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[FAST HEARTBEAT HAS MANY CAUSES]

Question: I have had a problem with fast pulse for about three months now. When I am sitting quietly it is as slow as 111, but at times it is 130. What can be done for this?

Answer: The heart is an amazing organ. It works constantly, starting before birth and continuing until the time of death. Your heart uses feedback from different areas of the body to help determine the rate of its beating. Especially important are the blood pressure levels in the brain and kidneys and the amount of oxygen reaching the muscles.

Babies have a faster heart rate than do adults, and sedentary adults have a faster resting rate than do their athletic counterparts. A resting heart rate of 111 is not unusual for a baby, but it certainly is for an adult, even one who is sedentary. Most adults have a resting heart rate of 90 or less, and very physically fit adults may have one in the 50s. Remember that the heart rate you use to compare with these norms should be taken after you have been resting for about 10 minutes and feel calm emotionally. This is because the heart rate increases both during exercise and when you are feeling nervous.

There are several conditions that cause a fast resting heart rate, a situation we doctors describe as tachycardia. Though we use this single word to describe all cases, tachycardia can be broken down into two groups: those with a regular rhythm and those with an irregular one.

Tachycardia with an irregular rhythm can be caused by a potentially serious heart condition called atrial fibrillation. This usually develops because of heart disease. There are other conditions that cause an irregular rate, too. Some of them aren't a sign of serious heart problems, but some are. Therefore, anyone with tachycardia and an irregular rate should see his or her physician for an electrocardiogram (EKG). This common test may identify the specific cause of the problem, but often additional tests are needed, too.

Tachycardia with a regular rhythm can, likewise, have several causes. It may develop as the consequence of the heart's natural pacemaker setting the cadence of contractions higher than is necessary for the level of physical exertion. This can occur as a consequence of an overactive thyroid gland, other hormonal abnormalities, heart disease, or for no specific identifiable reason at all.

I have seen a number of patients who had tachycardia from a side effect of medicine they took. The decongestants found in cough, cold and sinus remedies are the most common drugs that do this, but there certainly are many others.

Now, to answer your question about what can be done to help your tachycardia. The treatment depends upon the cause, so you will need to see your doctor for a treatment designed specifically for you. If your family doctor can't help, then try a cardiologist.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.