Angina and tachycardia: when a fast heartbeat matters

A rapid rhythm also shortens the time when coronary blood flow supplies the heart between beats. Chest discomfort together with a racing heartbeat deserves medical assessment because the cause of the fast rate and the stability of the angina both need consideration.

Tachycardia means the heart is beating faster than expected for the situation. It may follow exertion, fever, dehydration, pain, stress or stimulants, or it may come from an abnormal heart rhythm. Faster pumping raises oxygen demand. In someone whose coronary arteries cannot deliver enough extra blood, angina may present with chest pressure or tightness. Palpitations, dizziness or breathlessness can accompany the episode, but they do not identify the rhythm on their own.

Stop exertion, sit somewhere safe and follow the personal angina plan supplied by your clinician. Do not take extra heart medicine unless that plan specifically directs it. If the episode settles, record whether the pulse felt regular or irregular, what started it, associated symptoms and how the chest discomfort responded. Avoid energy drinks, decongestants or other stimulants until a clinician advises whether they are suitable. An electrocardiogram may help identify a rhythm problem, although intermittent episodes sometimes require longer monitoring.

Call emergency services if a rapid heartbeat occurs with new or severe chest pain, marked breathlessness, fainting, confusion, heavy sweating, or discomfort spreading to the arm, jaw, back or shoulder. Emergency assessment is also needed when chest symptoms persist after you follow your prescribed angina plan. Do not drive yourself. Even without these warning signs, arrange prompt review for repeated unexplained racing episodes, a new irregular pulse, or angina occurring more readily than before.

Ask what might be driving the fast rate, whether an electrocardiogram or rhythm monitor is appropriate, and which medicines or stimulants could contribute. Confirm how to use your angina reliever when palpitations occur and which pulse or symptom changes should lead directly to emergency care.