How to Identify Heart Arrhythmias
Heart arrhythmias occur when the heart is beating too fast, too slow or irregularly as a result of problems with the electrical impulses within the heart. Although arrhythmias are usually relatively harmless, they can produce more serious symptoms over time if left untreated. Therefore, it is important that arrhythmias are identified early on, so they can be closely monitored.
Know what is meant by the term "arrhythmia".Electrical impulses in the heart direct the heart beat. The normal heartbeat is about 60 to 100 beats per minute (about 100,000 beats a day). When the electrical impulses are disturbed and do not work properly, it causes heart rhythm problems.
- The heart can beat too fast (tachycardia) or too slow (bradycardia) or it can beat irregularly (atrial flutter and atrial fibrillation), these abnormalities in the normal rhythm of the heartbeat are known as heart or cardiac arrhythmias.
- This condition can be harmless if palpitations occur occasionally, but there are instances that the signs and symptoms persist for a long period of time that cause discomforts to an individual and could be life threatening.
Recognize the potential symptoms of arrhythmia.A heart arrhythmia may not demonstrate any symptoms. The health care provider can only discover an abnormality in the heart beat upon performing physical examinations. The doctor will take the pulse, listen to the heart and perform certain diagnostic exams to detect abnormalities in the heart rhythm. If symptoms develop in heart arrhythmia it may include:
- Palpitations or irregular heartbeat. This occurs as a result of the disturbance in the electrical impulses of the heart.
- Shortness or difficulty in breathing. Disturbance in the electrical impulses of the heart affects its pumping action, therefore, unable to supply blood to the vital organs such as the lungs. Without sufficient blood, the lungs cannot perform its function well.
- Chest pain. Because the heart is not pumping enough blood to the vital organs, pain receptors near the heart sends signal to the brain and a burning, sharp or heavy feeling in your chest are felt.
- Dizziness, mental confusion, lightheadedness and fainting spells. Because the heart is not pumping enough blood to the vital organs such as the brain, the level of consciousness of the person is altered.
Understand the possible causes of arrhythmia.A fast or slow heartbeat does not necessarily indicate an abnormality in the heart rhythm. The heart rhythm can be affected by anxiety, activity and medications. Heart arrhythmias can be caused by:
- Heart disorders. Endocarditis, myocarditis and rheumatic fever can damage the heart and its valves that affects the proper functioning of the heart.
- Fluid imbalance. Dehydration or depletion of potassium or other electrolytes may trigger the development of cardiac arrhythmia.
- Certain medications. Some drugs including digitalis, stimulants, and diuretics, as well as overdoses of cocaine, marijuana or antidepressants can lead to cardiac arrhythmia.
- Heart attack. This medical condition causes injury to the heart.
- Healing process. Surgery involving the chest and heart can affect the rhythm of the heart as it undertakes healing.
- Thyroid gland disorders
Be aware of the risk factors.The risk factors for arrhythmia include:
- Advancing age
- Excess consumption of caffeine or alcohol
- High blood pressure
- Kidney disease
Get an electrocardiogram (ECG or EKG).This painless procedure is the standard clinical tool for diagnosing arrhythmias. It is done by placing small patches or stickers across the chest area and electrodes on each arms and legs. The combinations of the electrodes shows different tracings of the heart’s electrical activity and it is recorded on a paper or in the computer.
- After the procedure, the ECG result will show three major waves. The first wave is the P wave, it records the activity of the atria. The second and the largest wave is the QRS wave, it records the electrical activity of the ventricles. And the third wave is the T wave, it records the heart’s return to its resting state.
- The doctor will interpret the ECG result by studying the shape and sizes of the waves, the time interval of the waves and the heartbeat and regularity. By measuring time intervals on the ECG, the doctor can determine how long the electrical wave takes to pass through the heart and understand whether the electrical activity is normal or slow, fast or irregular.
- By measuring the amount of electrical activity passing through the heart muscle, a cardiologist can detect if there are disturbances in the parts of the heart. It can identify enlargement and overfunctioning of the heart.
Wear a Holter monitor.This is a small, portable ECG recorder that continuously documents the electrical activity of the heart for the given measurement period. The health care provider attaches the electrodes to the chest and it is connected to a portable, battery operated recorder that can run for 24 to 48 hours.
- During the procedure, the patient tested is allowed to perform his normal activities. The patient is then advised to keep a diary where he can document his activities and the symptoms experienced while under the procedure. The importance of the diary is it assists the health care provider to compare the activities and symptoms to the recorded electrical signals of the heart.
- After the given measurement period, the computer instantly analyzes the records and detects heart rhythm disturbances that occurred during the procedure.
Use a transtelephonic monitor (or event recorder).This is recommended if the symptoms of cardiac arrhythmias occur rapidly or irregularly. The small recorder used in the patient's home for a month or two.
- The individual tested for the presence of cardiac arrhythmias is advised to turn on the device and attach the recorder with bracelets, finger clips or patches under the arm when he experiences symptoms of the condition.
- The heart rate and rhythm during the symptom attack will be recorded and stored in the event monitor. If possible, the ECG will be immediately transmitted to the cardiologist to be analyzed.
Undergo treadmill testing (Exercise Stress Test or Stress Test).This test is performed in people with arrhythmias where the cause is suspected to be aggravated by exercise. It is important to know what specific exercise will worsen the condition of arrhythmia, so it can be avoided.
- During the test the person is hooked into an equipment to monitor the heart activities. The person is then directed to walk slowly in place on a treadmill and as the procedure goes on, the speed of the treadmill is gradually increased and it is tilted to produce the effect of going up a small hill.
- The person may be asked to breathe into a tube for couple of minutes. The test can be stop anytime if needed. After the procedure, the patient is then allowed to sit or lie down to monitor his heart and blood pressure.
- While on the treadmill, the person’s heart rate and rhythm is being monitored. The presence of a health care provider is necessary during the test to aid when unexpected scenario happens.
Agree to a tilt-table test.Fainting spells or syncope is one of the symptoms of cardiac arrhythmia. If this happens repeatedly, a tilt-table test is recommended to indicate the heart rate and blood pressure when the person changes positions from lying to standing.
- An intravenous line is inserted aseptically as a precaution in case medication is needed if the cause of syncope is detected during the test. The medication can help prevent the recurrence of syncope.
- The test is normal if the average blood pressure stays stable as the table tilts upward and the heart rate increases by a normal amount.
Try electrophysiologic testing - (EP study).Temporary electrode catheters are inserted through peripheral veins or arteries into the atria, ventricles or both, and are positioned along the conduction system of the heart under local anesthetic.
- The test records cardiac electrical signals and monitors the range of electrical impulses during each beat which helps locate the heart block. This test also shows where tachycardia originates.
- The ability to electrically stimulate the heart at programmed rates and persuade precisely timed premature beats lets a doctor evaluate electrical properties of the electrical conduction of the heart. It also triggers dormant tachycardia or bradycardia.
Undergo an esophageal electrophysiologic procedure.A thin, soft and flexible plastic tube is inserted into the nostril and placed in the esophagus. The esophagus is located near the atria so it can give a more accurate ECG reading.
- An electrical stimulator can be used to make the heart beat faster and will restart arrhythmia.
- During the procedure, certain medications can be tested to identify which is the most effective drug to treat certain types of tachycardia.
Go for a transthoracic echocardiography (TTE).This is a non invasive and painless test that uses ultrasound waves to provide images of the heart’s size, structure and motion that could lead to arrhythmia.
- The technician asks the patient to turn on his left side and a gel is applied to the chest and the transducer is moved over the chest.
Get an echocardiogram.This test uses ultrasound waves to show the heart’s structure and movement while beating. It is a simple and painless test that provides valuable information and images about a heart with an arrhythmia.
Sources and Citations
- Mayo Clinic Staff (2013, February 27). Heart arrhythmia. In mayoclinic.org. Retrieved from
- John Hopkins Medicine (n.d.). Cardiac Arrhythmias. In hopkinsmedicine.org. Retrieved from
- American Heart Association (2012, December 7). Common Tests for Arrhythmia. In heart.org.
Video: Diagnosis of Arrhythmias
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