When should I be worried about an irregular heartbeat?

Medically reviewed on March 17, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is an irregular heartbeat?
• You think you might have an irregular heartbeat—when should you see a healthcare provider?
• Learn more about your health needs with Everlywell
• Related content

If you’ve ever felt like your heart is beating erratically, you may have asked yourself, “When should I be worried about an irregular heartbeat?”

If your heart beats too quickly, too slowly, or in an irregular pattern, you might have a condition called an arrhythmia [1]. There are multiple different types of arrhythmias, and they can be caused by (or can create) a variety of health conditions—which can be either minimally concerning or life-threatening.

This guide will break down the basics of a cardiac arrhythmia and when you should be worried about potential heart irregularities. Before you continue reading, keep a critical takeaway in mind: If you’re experiencing chest pains, shortness of breath, lightheadedness, or trouble moving, you should seek emergency medical attention [2]. Even if your arrhythmia isn’t serious—or if you aren’t experiencing arrhythmia to begin with—it’s always best to address cardiac symptoms with an abundance of caution.

What is an irregular heartbeat?

An arrhythmia—or an irregular heartbeat—is a problem with [1]:

• Your heart rate (the speed of the beat of your heart), and/or
• Your heart rhythm (the pattern of your heartbeat)

However, it is important to remember that arrhythmia and heart palpitations are different. Heart palpitations are short-term, fast heartbeats that typically last seconds or even minutes. On the other hand, a cardiac arrhythmia is an irregular heart rhythm that can last days or even years.

Let’s break down three different types of arrhythmias you might be experiencing, the potential causes, and more.

Tachycardia (fast heartbeat)

Tachycardia is one type of heart arrhythmia that describes a rapid heartbeat [3]. But tachycardia is distinct from the increased heart rate you might experience while you’re exercising or in a stressful situation—if your heart rate is higher than average while you’re relaxed, you may be experiencing tachycardia symptoms.

Tachycardia is a heart rhythm disorder that can result from various physiological causes, including [3]:

• Atrial flutter – Fast contractions in the atrial chambers of the heart
• Atrial fibrillation – Discoordination between the atria and the ventricles
• Prolonged QT intervals – Long “recharge” periods between heartbeats
• Heart disease – A variety of chronic cardiac symptoms (like arterial blockage)
• Myocarditis – Inflammation of the middle of the heart, which can be caused by viral infection, hypothermia, or heart transplant rejection
• Hypoxia – Lack of oxygen circulating in the bloodstream
• Hypoglycemia – Low blood-glucose levels
• Pulmonary embolism – A blood clot in the lungs

While the conditions above can cause tachycardia, a fast heartbeat might be the first warning sign of some of the issues. Identifying them as soon as possible could be critical to preventing permanent or major cardiac injuries.

Bradycardia (slow heartbeat)

The second type of arrhythmia is bradycardia—a slower-than-normal heartbeat [4]. In adults, bradycardia generally describes an irregular heart rhythm slower than 60 beats per minute (bpm).

Some common causes of bradycardia include [4]:

• Chest injuries or trauma
• Heart disease or past strokes
• Myocardial infarction (heart attack or cardiac arrest)
• Radiation therapy
• Lyme disease
• Myocarditis
• Sleep apnea
• Responses to drugs, including lithium, narcotics, beta-blockers, cannabinoids
• Anorexia nervosa
• Hypoxia

The list above isn’t exhaustive, as there are numerous other potential causes of bradycardia. If you suspect that your heartbeat is slower than normal, you may have other symptoms like [4]:

• Fatigue
• Lightheadedness
• Dizziness
• Intolerance to exercise
• Angina (chest pains)
• Decreased cognitive performance

Premature heartbeats

Premature heartbeats—premature ventricular contraction (PVC)—are the final type of heart arrhythmia. Premature heartbeats can occur when the Purkinje fibers (tissues located in the inner ventricular walls) initiate heartbeats instead of the sinoatrial (SA) node [5].

Simply put, early electrical signaling can cause your heart to beat too early, creating a longer-than-normal pause between two beats.

PVCs can be isolated or can occur in doublets or triplets. In most cases, they don’t have any known causes—they typically occur spontaneously. However, healthcare experts have determined a few risk factors for developing premature heartbeats, including [5]:

• Old age
• Hypertension
• Hypomagnesemia (magnesium deficiency)
• Hypokalemia (potassium deficiency)
• Undiagnosed stroke or heart disease

Males and Black Americans are also at a statistically higher risk for developing PVCs [6].

You think you might have an irregular heartbeat—when should you see a healthcare provider?

If you suspect that you may have an irregular heartbeat or any other heart condition, you should consider:

• Documenting your symptoms – Monitor your pulse regularly, writing down the number of beats per minute and any qualitative observations. If you have access to a blood pressure cuff or pulse oximeter, consider using these tools and documenting your results.
• Making an appointment with a healthcare provider – If you suspect that you have cardiac symptoms, but you’re not in pain, you may be able to wait until your next available opportunity for a checkup. However, any sudden changes or major heart condition symptoms should be taken very seriously.
• Seeking emergency medical treatment – If you’re experiencing shortness of breath, trouble standing, stroke symptoms, confusion, chest pain, or any other major cardiac symptoms, contact emergency medical services right away. If you’re experiencing a cardiac emergency, time is of the essence.

Not all arrhythmias (nor the causes) are equally severe. However, healthcare experts recommend consulting your provider or emergency care center anytime you think you might be in danger of cardiac injury.

Learn more about your health needs with Everlywell

“When should I be worried about an irregular heartbeat?,” you ask. The answer is, “It depends.” While any suspected cardiac abnormalities should be examined by a healthcare provider, you should seek emergency medical attention if you think you’re experiencing a major cardiac event. Talking to a certified healthcare provider will also help you answer questions like “Is heart disease curable?,” or “Can you have a heart attack and not know it?” They can also give you advice on how to prevent or manage these conditions.

At Everlywell, we create the space for people to take charge of their own health—to discover new insights about their personal health history, and to meet their wellness goals with help from medical experts. Over one million patients trust our platform to schedule telehealth appointments, order and use at-home collection kits, and manage their health benchmarks. Check out one of our heart health tests for a comprehensive look at your heart.

This test and other tests (including HbA1c and the Cholesterol and Lipids Test) are also available to you when you join the Everlywell+ at-home heart health membership, so you can stay on top of your heart health an on ongoing basis.

Learn more about how Everlywell is making healthcare more accessible, simple, and convenient than ever before.

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References

1. What is an arrhythmia? National Heart Lung and Blood Institute. URL. Accessed February 13, 2023.
2. Heart attack, stroke and cardiac arrest symptoms. www.heart.org. URL. Accessed February 13, 2023.
3. Henning A, Krawiec C. Sinus tachycardia - statpearls - NCBI bookshelf. National Library of Medicine. URL. Published August 8, 2022. Accessed February 13, 2023.
4. Hafeez Y, Grossman S. Sinus bradycardia - statpearls - NCBI bookshelf. National Library of Medicine. URL. Published August 8, 2022. Accessed February 13, 2023.
5. Farzam K, Richards J. Premature ventricular contraction - statpearls - NCBI bookshelf. National Library of Medicine. URL. Published August 8, 2022. Accessed February 13, 2023.
6. Simpson RJ, Cascio WE, Schreiner PJ, Crow RS, Rautaharju PM, Heiss G. Prevalence of premature ventricular contractions in a population of African American and white men and women: The atherosclerosis risk in communities (ARIC) study. American Heart Journal. 2002;143(3):535-540. doi:10.1067/mhj.2002.120298.