Heart Arrhythmia – Symptoms and Causes

Overview

Heart rhythm problems happen when the electrical signals that control your heartbeat don’t work correctly. These issues can make your heart beat too fast, too slow, or in an uneven pattern.

While some rhythm changes are normal (like a faster heartbeat during exercise or slower beats during sleep), others may need medical attention.

Heart rhythm disorders can cause feelings of fluttering, pounding, or racing in your chest. Some are harmless, but others can be dangerous.

Doctors can treat these problems with medicines, special devices like pacemakers, or medical procedures. Living a heart-healthy lifestyle helps prevent some rhythm disorders.

Rapid Heart Rhythms

When your heart beats faster than 100 beats per minute, doctors call it tachycardia. Several types exist:

Atrial Fibrillation (AFib)

• Creates chaotic, uncoordinated rapid heartbeats
• May come and go on its own or need treatment
• Increases stroke risk
• Feels like fluttering in the chest

Atrial Flutter

• Similar to AFib but with more organized beating patterns
• Also linked to higher stroke risk
• Often causes a steady, fast pulse

Supraventricular Tachycardia

• Starts in heart areas above the lower chambers
• Causes sudden episodes of pounding heartbeats
• Typically starts and stops abruptly
• May make you feel dizzy or short of breath

Ventricular Fibrillation

• Very serious condition where lower chambers quiver instead of pumping
• Can cause death without immediate treatment
• Often happens in people with existing heart disease
• Requires emergency care

Ventricular Tachycardia

• Begins with faulty signals in the lower heart chambers
• Prevents proper blood filling and pumping
• May be tolerated in healthy hearts
• Becomes a medical emergency in those with heart disease

Slow Heart Rhythms

A heart rate below 60 beats per minute is bradycardia. This isn’t always a problem – physically fit people often have lower resting heart rates.

However, if your slow heartbeat means your body isn’t getting enough blood, you might have one of these conditions:

Type	Description	Common Causes
Sick Sinus Syndrome	Heart’s natural pacemaker doesn’t work properly	Scarring near sinus node, aging
Conduction Block	Electrical pathway blockage slowing or stopping signals	Heart disease, medication side effects, aging

People with slow heart rhythms might feel:

• Dizzy or lightheaded
• Unusually tired
• Short of breath
• Confused at times

Early Heartbeats

Extra beats that occur before your regular heartbeat is due are called premature heartbeats. These come in two main types:

1. Premature Atrial Contractions (PACs) – extra beats from the upper heart chambers.
2. Premature Ventricular Contractions (PVCs) – extra beats from the lower heart chambers.

These early beats often feel like your heart “skipped” a beat, though what actually happened is an early beat followed by a pause.

Most people experience these occasionally, and they’re usually harmless. However, they can sometimes trigger longer-lasting rhythm problems in people with heart disease.

Common triggers for premature beats include:

• Stress or anxiety
• Too much caffeine or nicotine
• Heavy exercise
• Lack of sleep
• Some medications

While most premature beats don’t need treatment, very frequent ones should be checked by a doctor. In rare cases, having many premature ventricular beats over time could weaken the heart muscle.

Signs and Symptoms

A heart rhythm problem might not cause any noticeable symptoms. Sometimes doctors find irregular heartbeats during regular checkups for other health issues.

You might experience these symptoms if you have a heart rhythm problem:

• Fluttering or pounding feeling in your chest
• Fast heartbeat
• Slow heartbeat
• Chest pain
• Trouble breathing

Other possible symptoms include:

• Feeling anxious
• Extreme tiredness
• Dizziness or lightheadedness
• Sweating
• Fainting or near-fainting episodes

When You Should Get Medical Help

If you notice your heart beating too quickly, too slowly, or skipping beats, schedule an appointment with your doctor. They might refer you to a heart specialist (cardiologist).

Seek emergency care immediately if you have:

• Chest pain
• Difficulty breathing
• Fainting

Always call 911 if you think you might be having a heart attack.

One dangerous type of heart rhythm problem called ventricular fibrillation can cause blood pressure to drop suddenly. This can make someone collapse within seconds. Their breathing and pulse will stop soon after.

This is a life-threatening emergency requiring immediate medical attention. It’s the most common cause of sudden cardiac death.

If someone collapses with a possible heart rhythm problem:

1. Call 911 right away
2. If no one nearby knows CPR, perform hands-only CPR:
   • Push hard and fast on the center of the chest
   • Aim for 100-120 compressions per minute
   • Continue until help arrives
   • You don’t need to give mouth-to-mouth breathing

CPR helps keep blood flowing to vital organs until the heart can be restarted with an automated external defibrillator (AED).

If an AED is available:

• Have someone get it
• Follow the voice instructions
• No special training is needed
• The device will only deliver a shock when appropriate

Causes

The heart depends on electrical signals to create a steady, regular beat. These signals follow a specific path through the heart’s chambers to make it pump blood properly.

The heart has four chambers – two upper chambers (atria) and two lower chambers (ventricles). Electrical signals begin in a group of cells called the sinus node at the top of the heart.

These signals travel through the atrioventricular (AV) node between the upper and lower chambers. This process creates the heartbeat.

A healthy heart typically beats 60-100 times per minute when at rest. Several factors can disrupt this normal rhythm:

• Heart damage: Heart attacks or scarring from previous heart attacks.
• Blood flow problems: Coronary artery disease.
• Structural changes: Conditions like cardiomyopathy.
• Health conditions: Diabetes, high blood pressure, thyroid problems, sleep apnea.
• Infections: Including COVID-19.
• Substances: Alcohol, caffeine, some cold and allergy medicines.
• Lifestyle factors: Smoking, drug use, stress, and anxiety.

Some people may also have genetic factors that affect heart rhythm. When these factors interfere with the heart’s electrical system, arrhythmias can develop.

Risk Factors

Several factors can increase your chance of having heart rhythm problems:

Heart Conditions

• Coronary artery disease and narrowed arteries
• Previous heart attack or heart surgery
• Heart valve problems
• Heart failure
• Cardiomyopathy (heart muscle disease)
• Birth defects affecting the heart

Medical Conditions

• High blood pressure can stiffen heart walls and change how electrical signals travel
• Thyroid problems (both overactive and underactive)
• Obstructive sleep apnea, which can lead to slow or irregular heartbeats
• Electrolyte imbalances (potassium, sodium, calcium, or magnesium)

Lifestyle Factors

• Drinking too much alcohol
• Consuming caffeine
• Using tobacco products
• Taking certain medications, including some cold remedies
• Using supplements that affect heart rhythm
• Using illegal drugs, especially stimulants like cocaine or amphetamines

When electrolytes in your blood become too high or too low, they can disrupt the electrical signals that control your heartbeat. This makes it harder for your heart to maintain its normal rhythm.

Some stimulants can make your heart beat faster than normal. In severe cases, illegal drugs may cause dangerous heart rhythms or even sudden death from ventricular fibrillation.

People with sleep apnea often experience pauses in breathing while sleeping. This condition is linked to various heart rhythm problems, including atrial fibrillation.

Possible Problems

Heart rhythm problems can cause several serious health issues:

• Blood clots that might travel to the brain and cause a stroke.
• Heart failure is when the heart can’t pump blood properly.
• Sudden cardiac death in severe cases.

Preventing Heart Arrhythmias

Heart arrhythmias can often be prevented through lifestyle changes. Here are key steps to keep your heart rhythm healthy:

• Avoid smoking and limit caffeine and alcohol intake. These substances can trigger irregular heartbeats.
• Eat heart-healthy foods with low salt and saturated fat content. This helps control blood pressure.
• Exercise regularly. Aim for 30 minutes of activity most days of the week. Physical activity strengthens your heart.
• Maintain a healthy weight and manage stress through relaxation techniques.
• Control health conditions like high blood pressure, high cholesterol, and diabetes through proper medication and lifestyle changes.
• Get enough sleep. Adults should aim for 7–9 hours nightly. Good sleep helps regulate heart function.