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What is going on with my heart rate that shoots to 230 bpm? 

Hi, I am a 38 year old woman and for the past fourteen years (two or three times per year) I have experienced ten minute bursts of a weak feeling, racing heart which comes on without warning and stops abruptly. The attacks give me terrible indigestion and when they are happening I am convinced I am going to die. On average my heart shoots to 230 bpm. Can you help me? What could this be? 

submitted by Caroline from Edinburgh on 12/18/2012


by Texas Heart Institute cardiologist, Mehdi Razavi, MD     Mehdi Razavi, MD

Hello,  Indeed your symptoms may be due to an abnormality in your cardiac rhythm. Given the heart rate you have measured (assuming it is correct) you may have a form of tachycardia (literally "fast heartbeat"), the most common of which in a normal functioning heart is originating in the top chambers and are referred to supraventricular tachycardias (SVTs). There are a number of these types. Suggestive features include abrupt onset and termination and response to maneuvers such as bearing down as if having a bowel movement or vigorous coughing. Given the infrequency you may have to use a monitor which can be utilized on an outpatient basis to capture the events. You must visit with a cardiologist who can meet with and examine you. It is of course important to make sure there are no structural abnormalities (such as a weakened heart muscle function). Your symptoms are not suggestive but this should be looked at. SVTs in general can be easily treated and have an excellent prognosis. A more aggressive approach in your case (not necessarily recommended) may be simply to proceed to a study of the heart's electrical conduction system (electrophysiology study or EPS). This is because of the infrequency of  your episodes. During the EPS, the specialist may be able to reproduce and treat the arrhythmia should one be found. This may be a consideration if your symptoms have features typical of SVT as noted above. Most important step is to meet with a cardiologist.  

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Updated January 2013
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