Is a sudden heart rate of 195 bpm dangerous?

Question

Hello doctor,

I am a 49-year-old female, 5 feet 6 inches tall, and weigh 181 pounds. For many years (around seven or more), my heart suddenly races sometimes for no reason. My nurse friend taught me to cough to fix it, which worked. I also had an EKG and Holter monitor test around the same time, which were normal.

This has happened occasionally ever since, but lately the heart rate seems a lot higher, and coughing does not always stop it. Instead, I try not to panic and take deep breaths, and it resolves within a few minutes. But it is really scary.

This issue occurred when I was not overweight; also, I occasionally experience rapid heartbeat, sweating, nausea, and dizziness during episodes of severe diarrhea (a previous doctor said vagus symptoms).

It happened a couple of months ago, and just happened again tonight. My smart watch said my heart rate was 195 beats per minute. It felt very fast as well.

I have no other symptoms. No pain, no shortness of breath, and no dizziness. It happens randomly at rest when I do not feel stressed, but I feel stressed during and after.

Does this sound dangerous?
Are there any other techniques you can recommend?

I can provide minute-by-minute heart rate data from my watch for the two most recent events, if that helps.

I am taking a PPI (20 mg) once a day, a BCP (Yasmin), and Talcid as needed.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Episodes of fast heart rate need to be evaluated and treated properly. If your watch is showing a heart rate of more than 150 beats per minute, then it is essential to get the rhythm diagnosed and treated. It would have been helpful if you had shared your watch-recorded data during the episode of fast heart rate.

As you mentioned, these episodes have been present for the last seven years, and your previous EKG (electrocardiogram) and Holter monitor were normal, which points toward the benign nature of the condition. Nonetheless, your condition still needs proper diagnosis and management.

Common rhythms that can cause such fast heart rates and are potentially non-harmful include sinus tachycardia, premature atrial and ventricular contractions, supraventricular tachycardia, and multifocal atrial tachycardia. Other rhythms that are more serious and demand proper medical management include atrial fibrillation, atrial flutter, and ventricular tachycardia.

I would also like to review any basic workup done previously, including complete blood count, serum electrolytes, renal profile, and thyroid profile. I would also recommend an extended 72-hour Holter monitor and an echocardiogram to rule out any structural heart disease.

If the cause of tachycardia, or fast heart rate, is identified during the workup, then it should be treated accordingly. Fast heart rate is usually managed with medications such as beta blockers, calcium channel blockers, and other medications if these drugs cannot adequately control the heart rate.

I would recommend the workup as described above and management according to the cause.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have gone through your query and understand your concern.

This record (attachments were removed to protect patient identity), certainly shows a fast heart rate, but since there is no EKG (electrocardiogram), the nature of the rhythm cannot be diagnosed.

I would recommend the above-described workup, especially Holter monitoring and an echocardiogram, along with the blood workup as described above.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.