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Vertigo
Heart palpitations
Chest pain
Dizziness
Shortness of breath
Irregular heartbeat
Lightheadedness
High heart rate
Chest discomfort
Hard to breathe
Fluttering heart
Feeling faint
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A condition that affects the upper chambers of the heart, causing an abnormally fast heartbeat. It can come and go suddenly, lasting from a few minutes to a few days. It happens when there's an issue with the heart's usual signaling system and is typically not life-threatening. However, in rare cases, it can lead to cardiac arrest or loss of consciousness. It can affect anyone. Risk factors include heart or coronary artery defects or disease, emotional or physical stress/fatigue, and existing thyroid problems.
Your doctor may ask these questions to check for this disease:
Mild forms of this condition don't require treatment. If repeated episodes happen, doctors may recommend medication, maneuvers (taught by the doctor), or a carotid massage (performed by the doctor). Other procedures are available if symptoms remain severe.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Tatsuya Shiraishi, MD (Cardiology)
Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.
Content updated on Dec 5, 2025
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Q.
Heart Racing? Why Your Heart is Spiking & Medical SVT Next Steps
A.
A sudden racing or pounding heartbeat can be supraventricular tachycardia, where abnormal electrical signals make your rate jump to 150 to 250 bpm; common triggers include stress, caffeine, alcohol, dehydration, and some cold medicines, with symptoms like palpitations, lightheadedness, or shortness of breath. Next steps: track episodes, arrange medical evaluation with an ECG or monitor, try vagal maneuvers only if a clinician has taught you, and seek urgent care for chest pain, fainting, or severe breathlessness; treatments from medications to catheter ablation are often very effective. There are several factors to consider, so see below for important details that can shape your safest plan.
References:
* Katritsis DG, Josephson ME, Buxton AE, et al. 2023 ACC/AHA/HRS Guideline for the Diagnosis and Management of Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Nov 21;82(21):e185-e322. doi: 10.1016/j.jacc.2023.05.021. PMID: 37979607.
* Katritsis DG, Camm AJ. Supraventricular Tachycardia: An Overview of Diagnosis and Management. Circ Res. 2017 Mar 3;120(5):853-873. doi: 10.1161/CIRCRESAHA.116.309322. PMID: 28254848.
* Al-Khatib SM, Stevenson WG. Catheter Ablation of Supraventricular Tachycardia: A Review. J Am Coll Cardiol. 2019 Mar 19;73(10):1153-1166. doi: 10.1016/j.jacc.2018.10.076. PMID: 30871879.
* Zimetbaum PJ. Evaluation and Management of Palpitations. N Engl J Med. 2017 Oct 12;377(15):1441-1449. doi: 10.1056/NEJMcp1614052. PMID: 29020619.
* Bisson DL, Rosman D. Supraventricular Tachycardia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. [Updated 2023 Apr 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441860/ PMID: 28723000.
Q.
Abnormal ECG? Why Your Heart Is Racing and Medical Next Steps
A.
Abnormal ECG with a racing heart can be benign and treatable, caused by stress, caffeine, fever, or dehydration, or due to conditions like SVT, atrial fibrillation, thyroid disease, medication effects, and rarely dangerous ventricular tachycardia. There are several factors to consider; see below for details that can change your next steps. Seek urgent care for chest pain, fainting, severe shortness of breath, or a heart rate over 150 that will not slow, and review the recommended workup below such as repeat ECGs, Holter or event monitors, blood tests, echocardiogram, and treatments from lifestyle changes and medicines to cardioversion or ablation.
References:
* Chou KJ, Chen SA. Evaluation and Management of Patients with Supraventricular Tachycardia. Acta Cardiol Sin. 2020 Jul;36(4):307-317. doi: 10.6515/ACS.202007_36(4).0001. PMID: 32677840; PMCID: PMC7389868.
* Kim D, De Jesus O. Sinus Tachycardia. [Updated 2022 Dec 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: PMID: 30969562.
* Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Bybee KA, Daubert JP, Gillam LD, Hlatky MA, Joglar JA, Miller MA, Shah RU, Yancy CW. Ventricular Tachycardia: An Overview. J Am Heart Assoc. 2018 Aug 21;7(16):e008544. doi: 10.1161/JAHA.118.008544. PMID: 30138948; PMCID: PMC6170669.
* Balaji S, Balaji S, Balaji A. Approach to patients with palpitations. J Arrhythm. 2017 Aug;18(4):539-547. doi: 10.1007/s10840-017-0275-0. Epub 2017 Aug 16. PMID: 29094038.
* Nanchal R. Electrocardiogram Interpretation: The Basics. Crit Care Clin. 2022 Apr;38(2):209-224. doi: 10.1016/j.ccc.2021.12.002. Epub 2022 Jan 21. PMID: 35147481.
Q.
Heart Racing? Why You Need a Defibrillator + Medically Approved Steps
A.
There are several factors to consider: a racing heart can be harmless or a dangerous arrhythmia that needs immediate CPR and a defibrillator, especially with collapse, no pulse, chest pain, fainting, or severe shortness of breath. Early CPR and defibrillation improve survival, but not all fast rhythms require a shock. Clear, medically approved steps for emergencies and when you are stable including when to call for help, using an AED, doctor-advised vagal maneuvers, avoiding stimulants, and who might need an implantable defibrillator are detailed below.
References:
* Merchant RM, Topjian AA, Chan PS, et al. Part 5: Electrical Therapies: Automated External Defibrillators, Defibrillation, Cardioversion, and Pacing: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16 Suppl 2):S366-S393. doi: 10.1161/CIR.0000000000000913. Epub 2020 Oct 21. PMID: 33059293.
* Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct 21;43(40):3997-4126. doi: 10.1093/eurheartj/ehac262. PMID: 36014285.
* Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018 Feb 27;71(13):e77-e188. doi: 10.1016/j.jacc.2017.10.015. Epub 2017 Oct 30. PMID: 29097296.
* Katritsis DG, Calkins H, Contifaris M, et al. 2023 ACC/AHA/HRS Guideline for the Diagnosis and Management of Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Nov 21;82(21):1935-2091. doi: 10.1016/j.jacc.2023.05.011. Epub 2023 Nov 6. PMID: 37920786.
* Link MS. Electrical cardioversion and defibrillation. Card Electrophysiol Clin. 2017 Sep;9(3):477-484. doi: 10.1016/j.ccep.2017.05.004. Epub 2017 Jul 18. PMID: 28842095.
Q.
Heart Racing? Why Your Heart Is Reset by Adenosine & Medical Next Steps
A.
Adenosine resets certain racing heart rhythms in seconds by briefly blocking the AV node so normal rhythm resumes, most often for supraventricular tachycardia; the sensation can be intense but short, and it is given under close monitoring since it is not right for every rhythm or for some people with severe asthma. Afterward, plan on ECG and follow-up, consider ambulatory monitors, learn vagal maneuvers, review triggers, and discuss medicines or curative catheter ablation, while seeking emergency care for red flags like chest pain, fainting, or severe shortness of breath; there are several factors to consider, so see below for important details that can shape your next steps.
References:
* Page RL, Joglar FJ, Stevenson MA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2020 Dec 22;76(25):e141-e221. doi: 10.1016/j.jacc.2020.09.013. Epub 2020 Dec 4. PMID: 33279313.
* Lopes PS, Magalhães S, Pimentel-Nunes P, et al. Pharmacology of Adenosine. JACC Basic Transl Sci. 2017 Aug 28;2(4):420-432. doi: 10.1016/j.jacbts.2017.06.002. PMID: 29732448; PMCID: PMC5862214.
* Todd DM, Ducharme A. Acute management of supraventricular tachycardia. Eur Heart J Acute Cardiovasc Care. 2019 Jun;8(4):307-313. doi: 10.1177/2048872619830589. Epub 2019 Feb 19. PMID: 30784333.
* Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. Management of supraventricular tachycardia: an update. Herz. 2021 May;46(Suppl 2):142-154. doi: 10.1007/s00059-021-05047-9. Epub 2021 Mar 22. PMID: 33751104.
* Link MS, Huang DT, Chaitman BR, et al. Adenosine in the acute management of supraventricular tachycardia: a systematic review and meta-analysis. Resuscitation. 2019 Sep;142:156-166. doi: 10.1016/j.resuscitation.2019.07.009. Epub 2019 Jul 20. PMID: 31336184.
Q.
Heart Racing? Why Your Heart Needs a Cardiologist & Medically Approved Next Steps
A.
Heart racing can be normal after stress, caffeine, or exercise, but if it happens at rest, recurs, or occurs with chest pain, shortness of breath, dizziness, or fainting, you should see a cardiologist to check for arrhythmias like SVT or atrial fibrillation and other causes. There are several factors to consider, and medically approved next steps include tracking episodes, reducing stimulants, hydrating, prioritizing sleep, and getting tests like an ECG or monitor to guide treatments from lifestyle changes to medications, ablation, or blood thinners; see the complete details below.
References:
* Goyal A, Zègre-Hemsey JK. Palpitations: Evaluation in the Primary Care Setting. Curr Probl Cardiol. 2017 Nov;42(11):371-385.
* Katritsis DG, Camm AJ. Supraventricular Tachycardia: Diagnosis and Management. Heart. 2018 Dec;104(24):2004-2012.
* Calkins H, Hindricks G, Al-Khatib DM, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2023 Oct 17;148(16):e174-e346.
* Yap S, Zecchin RP, Gananadha S, et al. Indications for referral for cardiology assessment and investigation. Aust Prescr. 2016 Oct;39(5):161-165.
* Saravanan P, Saravanan P. Approach to cardiac arrhythmias: clinical evaluation and diagnostic tools. Postgrad Med J. 2017 Dec;93(1106):745-752.
Q.
Heart Racing? Why Your Heart is Over-Firing (SVT) & Medical Next Steps
A.
A suddenly racing or pounding heartbeat is often supraventricular tachycardia, a rapid rhythm from the heart’s upper chambers that starts and stops abruptly; it is usually not life threatening but can cause palpitations, lightheadedness, shortness of breath, or chest discomfort and may be triggered by stress, caffeine, alcohol, dehydration, or stimulants. Immediate care is needed for chest pain, fainting, severe shortness of breath, confusion, or a heart rate that stays above about 150, while outpatient next steps include ECG monitoring, blood tests, and treatments ranging from safe vagal maneuvers and medications to curative catheter ablation; there are several factors to consider, so see the complete details below to understand triggers, diagnosis options, and the right plan for you.
References:
* Page RL, et al. 2023 ACC/AHA/HRS Guideline for the Diagnosis and Management of Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2023 Sep 26;148(13):e278-e362. doi: 10.1161/CIR.0000000000001189. Epub 2023 Aug 24. PMID: 37622603.
* Adlan AM, et al. Supraventricular Tachycardia: Latest Developments in Diagnosis and Management. Card Electrophysiol Clin. 2023 Sep;15(3):397-409. doi: 10.1016/j.ccl.2023.04.004. Epub 2023 Jun 23. PMID: 37579998.
* Katritsis DG, et al. Diagnosis and Management of Supraventricular Tachycardia. Arrhythm Electrophysiol Rev. 2020 Dec;9(3):189-196. doi: 10.15420/aer.2020.25. Epub 2020 Dec 21. PMID: 33456885; PMCID: PMC7772658.
* Di Marco A, et al. Current guidelines for the management of supraventricular tachycardia. F1000Res. 2020 Feb 28;9:F1000 Faculty Rev-148. doi: 10.12688/f1000research.21204.1. PMID: 32174984; PMCID: PMC7051212.
* Adabag AS, et al. Mechanisms and Management of Supraventricular Tachycardias. Curr Probl Cardiol. 2018 Jan;43(1):1-38. doi: 10.1016/j.cpcardiol.2017.06.001. Epub 2017 Jul 27. PMID: 28803730.
Q.
Heart Racing? Why Tachycardia Happens & Medically Approved Steps
A.
Tachycardia can be normal or concerning: while faster beats with exercise or stress are common, a resting rate over 100 can signal dehydration, infection, anemia, thyroid or medication effects, or arrhythmias like SVT or ventricular tachycardia, and red flags such as chest pain, fainting, or severe shortness of breath need emergency care. Medically approved steps include slow breathing, hydrating, limiting stimulants, considering doctor-advised vagal maneuvers, tracking episodes, and seeking evaluation for persistent or frequent events with tests like an ECG and thyroid labs; there are several factors and treatments that may change your next steps, so see the complete guidance below.
References:
* Tachycardia. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
* Supraventricular Tachycardia. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
* Ventricular Tachycardia. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
* Brugada J, Katritsis DG, Arbelo E, Arribas JM, D'Avila D, de Chillón SM, Ferrero A, Blomström-Lundqvist C, Hindricks G, Kautzner J, Kuck KH, Lambiase P, Mont L, Sacher F, Scanavacca M, Stephen J, Tisdale JE. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia developed in collaboration with ALAECC: The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Mar 1;41(5):655-720. doi: 10.1093/eurheartj/ehz467. Epub 2019 Aug 29. PMID: 31475071.
* Sinus Tachycardia. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
Q.
Heart Racing? Why Tachycardia Isn’t Just Stress & Medically Vetted Next Steps
A.
A racing heart at rest is not always just stress; tachycardia means over 100 beats per minute at rest and can also come from arrhythmias like SVT or AFib, thyroid disease, anemia, dehydration, infections, or stimulants, and chest pain, severe shortness of breath, or fainting with it warrants emergency care. There are several factors to consider, and next steps range from cutting caffeine and hydrating to getting an ECG, wearable monitoring, and treatments like medications or catheter ablation. See below for the complete breakdown of causes, types, red flag symptoms, and step by step actions that could change what you do next.
References:
* pubmed.ncbi.nlm.nih.gov/34260279/
* pubmed.ncbi.nlm.nih.gov/29097296/
* pubmed.ncbi.nlm.nih.gov/34360677/
* pubmed.ncbi.nlm.nih.gov/30018318/
* pubmed.ncbi.nlm.nih.gov/32959663/
Q.
Racing Heart Over 65? Tachycardia Symptoms You Shouldn't Ignore
A.
If you’re over 65, a racing or irregular heartbeat at rest can signal tachycardia; watch for shortness of breath, dizziness, chest discomfort, confusion, or fatigue, and seek urgent care for fainting, chest pain or pressure, severe breathlessness, stroke-like symptoms, or a fast heartbeat that does not slow after a few minutes of rest. There are several factors to consider, including AFib and SVT, medication effects, thyroid problems, dehydration, electrolyte issues, and heart disease. See the complete answer below for the tests a doctor may suggest, home steps that can help, and treatment options that can guide your next steps.
References:
* Barón-Esquivias J, Roldán R, Roldán I. Cardiac arrhythmias in older adults: a review. Eur Heart J Suppl. 2021 Apr;23(Suppl B):B45-B53. doi: 10.1093/eurheartj/suaa169. PMID: 33790938; PMCID: PMC7990595.
* Patel N, Lim P, Khan F, et al. Clinical features and outcomes of supraventricular tachycardias in the elderly. Heart Rhythm. 2018 Jan;15(1):63-69. doi: 10.1016/j.hrthm.2017.09.006. PMID: 28917897.
* Mielczarek-Korzeniowska E, Król K, Goch A, et al. Specific Characteristics of Atrial Fibrillation in Older Adults: A Narrative Review. J Clin Med. 2023 Feb 1;12(3):1160. doi: 10.3390/jcm12031160. PMID: 36769623; PMCID: PMC9917540.
* Moreno J, Acosta J, Hernández-Romero D, et al. Ventricular arrhythmias in the elderly. Rev Esp Cardiol (Engl Ed). 2019 Jul;72(7):589-598. doi: 10.1016/j.rec.2019.01.006. PMID: 30737190.
* Khullar M, Kalsotra V, Zeeshan S, et al. Inappropriate Sinus Tachycardia and Postural Orthostatic Tachycardia Syndrome in the Older Population: Focus on Pathophysiology and Treatment. Front Cardiovasc Med. 2022 Mar 18;9:856429. doi: 10.3389/fcvm.2022.856429. PMID: 35372422; PMCID: PMC8976451.
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https://www.rcpjournals.org/content/clinmedicine/20/1/43Al-Zaiti SS, Magdic KS. Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management. Crit Care Nurs Clin North Am. 2016 Sep;28(3):309-16. doi: 10.1016/j.cnc.2016.04.005. Epub 2016 Jun 7. PMID: 27484659.
https://www.sciencedirect.com/science/article/abs/pii/S0899588516300314?via%3DihubMorady F. Diagnosis and cure of supraventricular tachycardia. Heart Rhythm. 2021 Apr;18(4):651-652. doi: 10.1016/j.hrthm.2020.11.010. PMID: 33795072.
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https://www.nejm.org/doi/10.1056/NEJMcp1111259