The heart should beat between 50 and 100 times per minute. Sometimes it speeds up and rises to more than 100p/min, in stressful situations or when doing sports. However, if there is dizziness, insecurity or loss of consciousness, a specialist should be consulted, as it may be an arrhythmia.
The activity of the heart is something that should go unnoticed by us, just as we do not notice the kidneys working and they do so continuously, day and night.
Functioning of the heart
The heart beats continuously, between 50 and 100 times per minute (at rest, during sleep, it can drop to 40 p/min and, with exercise, rise to almost 200 p/min), without us necessarily noticing it: on exertion, after a run, we may notice rapid palpitations, which will gradually decrease.
However, according to experts in cardiology, there are occasions when, either because the heartbeat loses its rhythmic characteristics or because its quantity and/or quality changes, we may notice sensations that are sometimes difficult to express.
Symptoms and manifestation of tachycardia and arrhythmia
The most frequent, possibly, is the perception of “flutters” in the chest, which may be accompanied by transient failures in the pulse wave (palpating it in the radial or carotid artery). They are generally caused by “extrasystoles”, premature beats (atrial, junctional or ventricular) that cause an early and ineffective contraction and, after a pause of just over a second, are followed by a heartbeat that pumps twice as fast as usual and “shocks” us with its momentum. Baseline and 24-hour electrocardiogram (ECG) recordings (Holter) help to document these phenomena, which are generally benign in the absence of structural heart disease.
Other times we may notice that, at rest, the heart fires and reaches frequencies not appropriate to the activity of the moment: often these tachycardias (beats above 100 p/min) begin and end abruptly, sometimes accompanied by a sensation of intense throbbing in the neck and with the need to urinate at the end of the episode: they are usually supraventricular tachycardias, often by “re-entry” (existence of electrical networks in the heart that allow the appearance of short circuits), some of them easily identifiable in the ECG (pre-excitation syndromes, WPW type, Wolf-Parkinson-White).
Frequency and identification of an arrhythmia
Over the years, from the age of 60 onwards, the appearance of rapid and irregular heartbeats, as if the heart were going crazy, due to “atrial fibrillation” is increasingly frequent and, many times, with sporadic onset and return to normal within a few seconds or minutes.
It is important in all these cases to try to quantify how many beats per minute there are, and whether or not they are rhythmic. Blood pressure measuring equipment can often help, since it indicates the pulsations and can indicate the existence of arrhythmia. When accompanied by dizziness, insecurity, sensation of possible or actual loss of consciousness (syncope), they are more alarming.
Finally, the least frequent (but most dangerous) are those associated with structural heart disease, acute or chronic myocardial infarction: if the heart rate exceeds 100 bpm at rest, whenever possible, it is advisable to go to a hospital where an ECG is performed without delay.
Causes and treatment of arrhythmia
Although the “flips” due to extrasystoles are very often associated with stressful situations, so frequent nowadays, it is always advisable to consult and perform an ECG and an examination to rule out cardiac pathology.
Fortunately, all the situations described can be treated and corrected, either by means of drugs or electrophysiological studies and the application of radiofrequency (ablation). In other cases they may justify the initiation of preventive treatment to avoid embolisms with anticoagulants.