Internal Medicine

Increased pulse

definition

A high pulse means that the heart is beating too fast or too often, i.e. the usual (physiological) Heart rate exceeds. The physiological heart rate varies with age, but should be between 60-80 beats per minute in adults. Frequencies between the upper range of the physiological frequency are already bad, but tachycardia is only spoken of as from 100 beats per minute and from frequencies of 150 beats per minute one speaks of pronounced tachycardia.

Symptoms

With increased pulse rates, the heart is no longer able to perform adequately Blood with oxygen in the Body circulation to pump. That's why symptoms like dizziness, nausea or Drowsiness. In rare cases, a short Faint occur. Furthermore, the patient can have an increased pulse shortness of breath or weakness (decreased resilience) complain. In addition, is a Fluttering in the chest to notice or a Palpitationsthat can be felt up to the throat.

Often used by one Sudden palpitations of the heart reports that begins suddenly and ends just as suddenly, regardless of certain situations, both at rest and after physical exertion. This benign form of the heart rate usually disappears on its own. Nevertheless, you should also have such attacks from you doctor clarify, as they can be dangerous for the person concerned, depending on the situation in which they occur (operating machines, driving a car).

You should also consult the doctor if the increased pulse does not go away by itself, if Pressure on the chest and shortness of breath, such as Shortness of breath occur and the Chest pain to get worse.

causes

A high pulse does not always have to have a high disease value. Strong emotions such as joy, excitement or fear can also increase the pulse rate. An increased heart rate can also occur after exercise or other physically demanding activities.

Further causes for an increased heart rate are shown below.

Most of the time, an increased pulse comes from the heart, as this controls the frequency of the heartbeat through the contraction of the cells of the heart muscle. There are certain regions on the heart, such as the so-called sinus node in the right atrium, which act like a pacemaker and operate at a certain frequency (physiological: 60-80 beats per minute) stimulate the heart muscle cells. If the heart is not supplied with enough blood or there are disorders in the sinus node, increased frequencies can arise.

In the following, some diseases of the heart that lead to an increased pulse are presented.

As already mentioned, the sinus node is responsible for the heart rate. If this works too quickly, for example in the case of fever or anxiety, an increased pulse occurs, which in this case is called Sinus tachycardia (> 100 beats / minute). Like sinus tachycardia, atrial flutter / fibrillation also emanates from the atria. The electrical stimulation of the atria is disordered and therefore the muscles of the atria flutter or flicker. With this clinical picture, there is not only an increased, but also an irregular pulse. In contrast to ventricular flutter or fibrillation, atrial flutter / fibrillation is not life-threatening and can even go unnoticed.

Ventricular flutter or fibrillation represents an acute danger for the person concerned, as the rapid contractions of the large chambers of the heart no longer effectively pump enough blood into the body and the patient can become unconscious as a result, or suffer respiratory and cardiac arrest. Ventricular fibrillation can arise through Ventricular tachycardias, by a fast heartbeat emanating from the chambers. Overall, the heart beats faster and less efficiently here too.

Another cause of an increased pulse can be disturbances in the conduction of impulses from the atria to the ventricles. Here is the first AV nodal reentry tachycardia called, which is not one of the dangerous forms of an increased heart rate. In this clinical picture, there are circular excitations between the atria and ventricles, which increase the pulse and often manifest themselves in a sudden but reversible palpitations.

That too Wolff-Parkinson-White Syndrome is a congenital conduction disorder in which there is an additional conduction between atria and ventricles. This anomaly can also go unnoticed for a long time and is not treated if there are no complaints. Complaints manifest themselves in a strong and sudden palpitations, which can even lead to unconsciousness. In this case there is an indication for therapy.

Cardiac arrhythmias can also cause an increased pulse. There are many different types of cardiac arrhythmias that should be examined by a doctor and some of them require treatment.

Furthermore, the effects of coronary artery disease or a heart attack, namely the lack of blood flow to the heart, can influence the conduction of stimuli in the heart and thus lead to an increased pulse. In addition, high blood pressure promotes the development of tachycardia.

However, not all forms of increased heart rate are associated with heart disease. Also hormonal fluctuations, such as an overactive thyroid (Hyperthyroidism) or during menopause in women, the heartbeat and thus the pulse accelerate. Also anemia (anemia) can lead to an increased heart rate. This anemia can be triggered on the one hand by large blood loss as a result of a serious injury, then the heart beats particularly quickly due to the shock, or on the other hand due to malnutrition, blood formation disorders or the like. In the context of the last-mentioned reasons, the increased pulse is caused by a regulation mechanism of the body through which the body tries to compensate for the lack of oxygen by increasing blood ejection.

The heart rate also increases if a blood clot (thrombus) an artery in the lungs is blocked (pulmonary embolism) or in the event of poisoning by mushrooms, medication, drugs (including nicotine and caffeine).

Read more on the topic: These are the causes of an increased heart rate

Circulatory problems

The complaints commonly summarized as circulatory problems are understood as a reduced blood flow to the brain, which in the worst case leads to fainting.

Often this complete breakdown of the circulatory system can still be prevented and the affected person can feel sudden dizziness, a brief feeling of weakness and a restricted window of vision. In order not to let this condition develop in the first place, normal blood pressure is able to pump the blood to the head even while standing. Since the blood pressure and the heart rate result in a certain volume of blood flow over time, the pulse has a compensatory function if the blood pressure is not high enough to achieve the required volume.
Put simply, this means: The body notices that the supply to the brain is insufficient. However, it cannot increase the blood pressure as quickly either and therefore tries to provide the required blood volume in a compensatory manner via an increased heartbeat frequency.

Heart rate changes from exercise

During sports increases the Heart rate automatically, as the heart has to beat more in order to supply the working muscles with sufficient oxygen and nutrients and to transport away the resulting breakdown products. The Musculature becomes increased blood supply and makes such a thing possible more effective performance. It's quite normal for that too after the sport of the Pulse yet increased for a while remains. This is because the body remains in its “activity mode” for a while and only gradually returns to its resting state. When he notices that the muscles are no longer being used as much, he reduces their blood flow and the heart rate drops again.

For people who regularly Endurance sports operate, it can be observed that the pulse does increases significantly during sport, but he in quiet situations most of time below the pulse of an average active person lies. That's because the heart themselves enlarged with regular physical activity and thus can transport more blood volume with one heartbeat than the heart of a normally active person. At rest, a lower heart rate is sufficient to pump sufficient blood into the organism.

Of course it can during sports due to the high heart rate too lighter to Cardiac arrhythmias come. Should be during or after exercise Racing heart or a irregular pulse occur, a medical examination is recommended to rule out serious causes.

Increased heart rate at rest

An increased heart rate is not necessarily to be equated with tachycardia (palpitations), since by definition this is only present from a value of more than one hundred beats per minute. But even with a pulse of more than 80 beats per minute, one can already speak of an increased pulse.

Typical diseases that cause an increased pulse are either an overactive thyroid gland, so-called hyperthyroidism, or a defect of the heart. The overactive thyroid becomes noticeable through a generally increased metabolism. The pulse generator of the heartbeat is additionally stimulated and thus increases the beat frequency.

"Heart defects" that cause an increased pulse are, for example, a weak heart muscle or various types of heart valve defects. In both cases, the heart fails to pump the required volume per beat, which is why it is forced to increase the beat frequency in order to achieve the required flow rate. Furthermore, cardiac arrhythmias could be responsible for a high pulse. However, the frequency is usually faster than 100 beats per minute. In such cases, the affected person usually feels a kind of heart palpitations himself.

Read more on the topic: High heart rate at rest

Increased heart rate at night

An increased heart rate at night is associated with a disease value, because physiologically, the heart rate should decrease when the person comes to rest. Waking up from nightmares can lead to an increase in heart rate, but no concrete reason can be identified should a medical examination take place.

Depending on the underlying disease, the pulse may be higher or lower. If, for example, there is heart failure or cardiomyopathy, the pulse is increased, but does not yet escalate into tachycardia. If, on the other hand, it is an actual cardiac arrhythmia, the pulse is usually higher than a hundred beats per minute even at night and should be clarified with a doctor as soon as possible in order to keep the complication rate as low as possible.

Increased heart rate due to stress

Stress also increases the heart rate via a messenger substance, the hormone adrenaline. This is an evolutionary holdover from times past. As a catecholamine, adrenaline increases the heart rate and at the same time increases blood pressure. For a short-term reaction, the release of adrenaline through stress is an essential reaction of the body.

A permanently increased stress, however, acts via the hormone cortisol, which develops a disease value with a permanently increased blood level. It is assumed that an elevated cortisol level is associated with a greater risk of arteriosclerosis and thus a greater risk of a heart attack or stroke.

Increased heart rate from alcohol

Alcohol affects the body and metabolic processes in a variety of ways. Some mechanisms are still not fully understood.

However, it is noticeable that many people report an increased heart rate or even cardiac arrhythmias after consuming alcohol. Even young people with a healthy heart can develop so-called holiday heart syndrome after moderate to heavy alcohol consumption, in which they suddenly develop atrial fibrillation and are often taken to a clinic. The arrhythmias usually resolve on their own.

Presumably alcohol affects the cardiovascular system in such a way that it leads to increased work of the heart (high pulse) and thus to increased blood pressure. The body is put under stress, so to speak, and reacts with increased activity of the sympathetic nervous system, which is generally active in stressful and active situations. At the same time, it is assumed that the antagonist of the sympathetic nervous system, the parasympathetic nervous system, is attenuated and thus its inhibiting effect on the cardiovascular system is reduced. These mechanisms could explain the increased heart rate after alcohol consumption.

Another explanation relates to the vasodilating effect of alcohol. As alcohol dilates the blood vessels, the heart reacts with an increased heart rate in order to maintain the blood supply to the organs. The blood sinks in enlarged vessels and the heart has to work harder to maintain the circulation. Fortunately, once the alcohol consumption is stopped and the body can break down the alcohol, the heart rate usually returns to normal quickly.

Read more on the subject below Palpitations from alcohol.

Increased heart rate from coffee

The heart-increasing effect of coffee is due to its ingredient, caffeine.

Caffeine is a substance with a slightly stimulating effect and is regarded by medical professionals as an addictive substance because it meets all the criteria of an addictive substance. In addition to increasing blood pressure, caffeine also increases heart rate. Depending on the dose of caffeine consumed, there may even be cardiac arrhythmias. After consumption, the maximum effect of the caffeine comes after about 20 minutes, which explains that the increase in pulse and blood pressure only set in after the coffee consumption. The effect lasts for a total of about two hours, so that the increase in heart rate after consuming coffee is a rapidly reversible increase in heart rate.

Increased heart rate with fever

A fever is naturally associated with an increase in heart rate. For every degree Celsius that the fever rises, the pulse increases by an average of ten beats per minute. Accordingly, the higher the fever, the faster the heartbeat. This is explained by the fact that the increased body temperature to a Widening of the blood vessels that want to release the excess heat through the skin to the environment.

Due to the enlarged blood vessels, however, the blood and the Blood pressure drops. The flow of blood is correspondingly slowed down in vessels that are wide open. In order to still be able to ensure an adequate supply of the various organs and tissues, the body has to increase the heart rate. In this way the circulation of the blood volume is improved again. The higher the fever, the more pronounced the widening of the blood vessels and the higher the heartbeat required to ensure efficient blood flow to all organs. Accordingly, a high heart rate in febrile patients is not a cause for concern. On the contrary, it even helps the patient to continue to care for his body optimally.

Please also read our topic on this Fever, dizziness and headache.

Increased heart rate with a cold

A high pulse rate during a cold or an infection is nothing unusual and, especially in connection with fever, it is highly physiological. While there should be only a few beats in the case of a harmless flu-like effect, the pulse can already be significantly increased with a fever. On the one hand, this is related to the body's defense reaction. The immune system or the body's defense cells need energy, which they receive with the help of oxygen. To ensure this increased oxygen supply, the heart pumps more often to generate more blood flow.
In the case of fever, there is another variable in addition to this fact. Namely the changed core body temperature. Since this is increased with a fever, the body tries to "heat up" the body by increasing blood transport. However, in such a case the pulse rate should not degenerate into tachycardia (rapid heartbeat), but about twenty to a maximum of thirty beats per Minute above the normal resting heart rate.If this is no longer the case, it is advisable to see a doctor.

Increased heart rate due to thyroid disease

Typical causes of an increased heart rate compared to the normal value can be a so-called hyperthyroidism; known as hyperthyroidism.

There are various possible causes for this, ranging from an autoimmune disease, Graves disease, to a pituitary adenoma. In most cases, however, you don't know exactly where the hyperfunction comes from, so that it doesn't really have any disease value. The thyroid hormones have an effect on the vegetative nervous system and ensure a general increase in drive.

People with hyperthyroidism, for example, also have a higher caloric expenditure, a greater urge to move around, can cope with less sleep and also have a higher resting heart rate.
Also read our topic: Symptoms of an overactive thyroid

Increased pulse during pregnancy

During pregnancy, the pulse rate naturally increases by about ten beats per minute. The reason for this is one of the numerous mechanisms of adaptation of the maternal body to pregnancy. The growing child must be well supplied with maternal blood so that it receives sufficient nutrients for its growth. Increased blood flow to the uterus is essential for this. Therefore, the mother's blood volume also increases. The increase in the heart rate allows the blood to circulate more strongly in the organism and supply the uterus and the child. Accordingly, some increase in heart rate is normal during pregnancy.

However, if the pulse is permanently high, this can also be unfavorable or even dangerous for mother and child. Normally during pregnancy the pulse only rises by about ten beats per minute, it is then usually not more than 100 beats per minute. A constant increase in the heart rate well above 100 beats per minute should possibly be clarified by a doctor. With permanently very high pulse frequencies, the pumping capacity of the mother's heart can deteriorate, so that her body and thus that of the baby are no longer optimally supplied with nutrients and oxygen. This can have undesirable consequences and lead to insufficient care for the child.

The increase in the heart rate during pregnancy occurs quite frequently in both singleton and twin pregnancies. There is no evidence that it is significantly more common in twin pregnancies. Of course, it also applies to twins that they can be undersupplied if the mother's pulse is permanently too high. Since twins are often born smaller than singly born babies anyway because they have to share the space in the uterus with their twin, this can become a danger for these children more quickly.

If a medical examination has been carried out and there is no serious cause for the increase in heart rate, in severe cases and depending on the work situation of the pregnant woman, an employment ban can be considered. However, this is only pronounced if there is actually a risk for mother and / or child if the pregnant woman continues her work. If the increase in heart rate can be controlled by general measures or by medication that is tolerated during pregnancy, there is usually no need to prohibit employment.

Read more on the subject at: Increased pulse during pregnancy

Increased heart rate during menopause

During menopause, the body goes through major hormonal changes. As a result, many women experience unpleasant side effects such as hot flashes with sweating, restlessness and sleep disorders. An increased pulse can also be part of it, as the hormonal changes also affect the autonomic nervous system.
This consists of the sympathetic and parasympathetic nervous system. While the parasympathetic nervous system is mainly active in resting situations, the sympathetic nervous system is responsible for controlling the organism during activity. The increase in heart rate and blood flow, sweating and restlessness are therefore due to an increased activity of the sympathetic nervous system.

Since it can take some time for the body to fully adapt to the new hormonal situation, recurrent increased pulse rates are not uncommon. However, if the pulse rate is permanently in the increased range (over 100 beats per minute) without slowing down in the meantime and if there are even rhythm irregularities, the symptoms should be clarified by a doctor. By writing an EKG, an initial classification of the rapid pulse rate or a rhythm disturbance can usually be made.

If the woman is worried by her increased pulse during the menopause, this unfortunately also favors the high pulse, since excitement contributes to an increased heart rate. It is therefore important to remain calm and, as a precaution, to consult a doctor if you are very worried. As a result, the fears can usually be quickly eliminated.

Read more on the subject below Menopause symptoms.

Increased pulse before ovulation

According to a company that sells measurement technology for cycle monitoring in women, there is a significant increase in pulse shortly before ovulation, i.e. immediately before the woman's fertile days. Otherwise, little is known in the professional world about the connection between pulse and female cycle.

According to the company's study, which was also carried out independently by the company, the increase in estradiol in the blood could be the reason for this. However, no causal relationships were investigated. Overall, however, the results must be viewed with the understanding that the company had an interest in the study showing a significantly increased pulse. So whether there is really a physiological increase in heart rate before ovulation cannot really be answered.

More on this: Concomitant symptoms of ovulation

Psychosomatic causes

The psychosomatic causes of an increased heart rate can include almost anything, with stress being by far the most common cause.

Due to the released cortisol, the body, which now sees itself in a "dangerous situation", automatically activates the so-called sympathetic nervous system and thus increases the heart rate. But other psychosomatic illnesses are also often associated with so-called vegetative symptoms. Somatization disorders or hypochondriac disorders are also known for this. While somatization disorders are characterized by the fact that almost every organ system can be affected, the hypochondriac disorder leads to fear of suffering from a dangerous disease. This fear, in turn, causes the heart rate to rise through the release of cortisol.

More on this: Persistent somatoform pain disorder

Increased heart rate after eating

An increased heart rate after eating can have various causes:

The cause is particularly often the consumption of caffeinated drinks with food. Caffeine activates the cardiovascular system and increases the heart rate.
However, a faster pulse after eating can also occur with underlying diseases, for example diabetes or after various bowel operations.
In these cases, the chyme that gets into the intestine removes fluid from the body, so that the heart rate is increased in a compensatory manner in order to ensure blood flow to the organs.
Especially in older people, the rising pulse after a meal can also be caused by the redistribution of blood after a meal. During digestion, the body increasingly distributes its blood to the gastrointestinal tract in order to quickly absorb the nutrients from food. As a result, the blood pressure in the systemic circulation can decrease and the heart subsequently increases the beat frequency to compensate for the "lack" of blood in other areas of the body.
If the person concerned also concentrates on a possible accelerated heartbeat, this usually leads to the pulse rising even more, as the vegetative nervous system reacts to the patient's concern.

Read more on the topic Palpitations after eating

Increased pulse before defecation

Unfortunately, there is no irrefutable connection between an increased pulse and bowel movements. Although some people with thyroid diseases report such phenomena, there is always a feeling of the almost collapsing cycle.
In addition, an increase in heart rate would be possible due to conscious muscle tension. When the stool begins to press, we have the option of actively tensing the anus muscle to prevent the stool from escaping prematurely. This muscle contraction, but possibly the associated slight stress, could lead to an increase in heart rate just before a bowel movement.

Increased heart rate due to back pain

The back pain that is typical in everyday life is usually not combined with a higher pulse, but produces only a slight pain that does not result in a significant increase in the beat frequency.
An increase in heart rate, on the other hand, causes the more serious acute illnesses. For example, a pulmonary embolism or a heart attack can make themselves felt as well as shortness of breath and a significantly accelerated pulse, as well as back pain. Their origin is neither the spine nor the back muscles, but a projected pain that originates from an internal organ and is felt in the back.
While “normal” back pain has its origin in the spine or muscles, back pain in combination with tachycardia is usually not dependent on movement and is often the symptom of a serious illness that is currently acute.

Increased heart rate due to histamine intolerance

Histamine intolerance is due to the potential lack of two enzymes in the body that are used to break down histamine. The lack of it can lead to an imbalance in the body between the absorption and breakdown of histamine, which is then shifted to the side of absorption. If sufficient or too much histamine has accumulated, symptoms similar to those of an allergic reaction occur in the body.
In addition to the formation of wheals and the so-called urticaria, palpitations, increased blood pressure and swelling of parts of the body also occur. Histamine intolerance is not seen as an independent allergy, but can appear in combination with allergies.

More on this:

Symptoms of histamine intolerance
How can you test for histamine intolerance?

Diagnosis

First of all, an anamnesis discussion is essential, during which the doctor can determine, among other things, how often and in which situations the increased pulse occurs. A blood count can also be informative. An increased pulse is diagnosed by touching the pulse and determining the frequency.

The doctor will also do a physical search and listen to the heart. In addition, an EKG (electrocardiogram), which records the spread of excitation over the heart and thus shows anomalies. This EKG can also be carried as a small device for 24 hours (long-term EKG) and thus records irregularities in the heart's activity over several hours, which the doctor can then evaluate. In addition, there is the possibility of the heart using ultrasound (Echocardiography) to examine the function and size of the heart and valves.

therapy

An increased pulse can usually be regulated by the person concerned with simple means, as it is often through stressful situations is triggered. In this context, it is helpful to relax and take the stress out of everyday situations. Numerous Relaxation techniques, how meditation, yoga up to progressive muscle relaxation or autogenic training can help. The increased pulse can also be passed through multiple deep inhalations and exhalations regulate. There nicotine and caffeine If the heartbeat and blood pressure increase, it is helpful to forego both in order to lower a high pulse.

Benign elevations can be treated with medication. Play here Medication a role that slow the heartbeat, like Calcium channel blockers or Beta blockers. Against that increased risk of thrombosis with atrial fibrillation is with Anticoagulants (Coumarins) worked. If the increased pulse has psychological causes Sedatives help.

In the case of the very dangerous Ventricular fibrillation / flutter is in any case one Defibrillation indicated to stop the rapid conduction of stimuli and allow a slower heart rate to re-emerge.
In general, an increased heart rate can be regulated by the patient himself through simple maneuvers, as well as through medication. If these treatment attempts do not respond, surgical interventions or similar measures are necessary in some cases.