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What Causes Fast Heart Beat With Normal EKG And ECG?

Posted on Sat, 17 Jan 2015

Question: Hi, my boyfriend is 23 years old , Three years ago he felt his heart was beating fast and therefore went to the doctors the next day, they said that your heart beat does seem slightly higher and thus we will refer you to a cardiologist, he went and got a EKG,ECG and a test involving injecting glucose . The glucose did decrease the heart rate... After the results came the cardiologist it is normal and you may have felt palpitations or heart mumurs which are not harmfull and very common. They made him into a outpatient and got holter examination which came normal aswell. The cardiologist examined this and said it is normal and there is nothing to worry about. At sleep the heart rate dropped to 50-60bpm and highest during the day went to 120bpm. The cardiologist said his heart beat is just faster naturally! Is this possible? Last week he went for a regular check up and they said his heart rate at the gp was 98bpm, however reading online that being on the upper end of the norm of 60-100 is dangerous. My boyfriend also used to go gym and dance classes for a whole year and did not have any symptoms. I feel worried can you please tell me why his heart rate is high generally. Thank you

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
I recommend doing other exams and to avoid, alcohol, cafe etc....

Detailed Answer:
Hi and thank you for asking!

I read your query and understood your concerns.

Your boyfriend has a normal HR although at the upper limits and he shouldn't worry to much for the moment. There's no imminent health danger for the moment as long as cardiac examinations were normal.

If your boyfriend was my patient I would have recommended doing some more examinations in order to find out the cause of HR at the upper limits:
- Blood works (exclude anemia)
- Hormonal test especially thyroid function.
- Electrolytes in blood

Also i would like to suggest your boyfriend:
- Avoid Alcohol, caffeinated drink, energy drink
- Avoid recreational drugs (cocaine)
- Increase physical activity
- Stop smoking

Hope you will find this helpful!
Wish you and your BF health!
Dr. Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (7 minutes later)

He has had his blood test done and they have not been able to find anything, he does not drink at all and does not smoke either, he does go to work on a normal basis and exercise has cut down, I just wanted to know if it is something for me to worry about regarding the future such as heart attacks, strokes and other things I have read on-line such as arrhythmias (but the tests would have detected these such as holter, EKG) , Also if the heart does beat at a regular rhythm then does that mean that the heart is healthy even if its at the higher end?

He is 23 years old so is it something dangerous or fatal for him that I need to take into account or worry about. There has been no symptoms for three years regarding chest pain, shortness of breathe and nausea.

I just wanted to confirm if he has heart disease or any heart condition. Very worried!

Thank you

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer:
If tests are ok, nothing to worry about your boyfriend heart.

Detailed Answer:
Hi back,

Thank you for following up.

If the tests he did resulted fine, (no anemia or thyroid problems) there is nothing to worry about.No fear for heart dsease.

All the best!
Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (15 minutes later)

Sorry so to clarify this means if his heartbeat is even at 98bpm during the day constantly and the checks up have been done there is no problem of any sorts of heart problems, Also his resting heart beat was at 98bpm at the doctors and blood pressure was told to be normal... Therefore does everyone vary in there resting heart beat , like one person may be okay with heart beat at 98 however another person may not be able to cope with it, are there are other factors involved in heart rate such as metabolism, it just worried me that his is on higher normal and not average . Also resting heart rate should be soon as you are awake therefore at doctors this means it may have been higher... So for future he needs to just manage his diet, exercise like every other individual needs too. And for heart attacks and strokes other things need to be considered aswell not just heart rate? Just need more advice on this. Thank you doctor

Answered by Dr. Benard Shehu (32 minutes later)

Brief Answer:
HR of 98 isn't associated with an increase risk of heart disease, stroke..

Detailed Answer:
Hi back,

His resting heart is 98 per minute which is the upper limits of norm. Although it's at the upper limits it's within norm and isn't associated with an increase risk of heart disease or stroke.

In the evaluation of the risk for heart attack or stroke there are five primary risk factor:
- Hereditary
- Dyslipidemia
- Hypertension
- Diabetes mellitus
- Smoking
As you can see even tachycardia (HR above 100/minute) isn't a major risk factor for stroke and heart attack.

However is recommended for person with HR at upper limits to increase physical activity and to avoid caffeinated or energy drink (he didn't drink alcohol or smoke).

This measure are taken to lower HR in the middle of the norm. For the moment there's no need for medication as long as this HR is well tolerated by him (asymptomatic).

Hope this was of help!
Wish you & him health!
Dr. Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (2 hours later)

You have been of great help Dr Benard . I have always worried about increasing the risk of stroke or heart attacks . I was also wondering what other ways can one lower there heart rate besides exercise .. And does asympotatic mean hes become immune to it or his body can deal with it. He is not on any medication or And lastly does this mean there is nothing to worry about as tests came normal so no heart arithymias, tach or XXXXXXX but just palpitations and heart mumurs. Are they common? However it is not impossible to lower the heart rate ? And there must be solutions to this right... Also is the resting heart rate bell curve very definite or do people fall outside the range and feel normal. And lastly if he suffered with anythink like tach or other heart issues would there be some symptoms shown over the three years in order to identify something! Just needed a clear description of this to make sure that heart problems are not so simple and it is much more complex with variety of factors .

Kind regards
XXXXXXX

Answered by Dr. Benard Shehu (9 hours later)

Brief Answer:
He tolerate well HR, nothing to worry and follow my advises...

Detailed Answer:
Hi back again,

With asymptomatic I mean that your boyfriend tolerate well the HR 98 and this is a good thing as long as cardiac examinations are normal. This is why i said that there's nothing to worry about.

Yes palpitations are very common in patients with HR at upper limits this is why all effort should be made in order to lower HR in the middle of the norm.

In such a case i would suggest the following advises in order to lower the HR:
- Avoid stressful situation
- Avoid drinking cafe, tea, coca cola, energy drink.
- Learn how to control HR by valsava maneuver (after taking a deep breath, strain the muscles in your abdomen for 5-10 seconds the same way you would to give a bowel movement.)
- Increase physical activity (Warm up running for 5 minutes. Then run fast for 1 minute and jog slowly for 1 minute. Repeat this procedure 5-10 times every day)
- Take fish oil or squid oil capsule.
- Eat a procardiac diet (plenty of fishes like salmon or sardines, whole grains, green leafy vegetables, nuts, and foods high in potassium like bananas and avocados.
- He can take supplements of Magnesium and potasium.

Wish you and your boyfriend all the best!
Dr. Benard

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar