When to Go to the ER for a Fast Heart Rate

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Senior woman holding stomach and chest in discomfort
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Most of the time, we don’t notice our heartbeat, which plugs away in the range of 60 to 100 beats per minute, on average. But sometimes, some of us will experience episodes where our hearts beat faster than this. Palpitations are one indicator, when you feel like your heart has skipped a beat or is flipping around in your chest. Often these are minor, short-lived bouts, lasting only a few seconds or minutes, that go away on their own. But sometimes, these can be signs of a more serious problem, one that warrants a trip to the emergency room. Learn more about fast heart rate and when it’s a danger sign requiring ER care.

Fast Heart Rate Causes

Fast heart rate, or tachycardia, is defined as a heart beating more than 100 times per minute. Sometimes a fast heartbeat is regular, but other times the beat is erratic, which is referred to as an arrhythmia. A fast heartbeat can occur briefly or can continue for a longer period of time. You may not even know you have a fast heart rate unless you are examined. You may or may not have other symptoms along with a fast heart rate.

Some issues that can cause a fast heart rate include:

  • Anemia (low red blood cell count)
  • Certain medications (over-the-counter decongestants, for example)
  • Excess alcohol consumption
  • Exercise
  • Overactive thyroid
  • Overuse of caffeine (such as too much coffee, energy drinks, tea or chocolate)
  • Poor physical conditioning
  • Sudden fright or shock
  • Use of illegal stimulant drugs, such as cocaine

Sometimes, eating certain foods or overeating can bring on a fast heart rate. This is because eating causes blood to be redirected to your digestive system, which can raise both your heart rate and blood pressure.

Certain foods also contain substances that can trigger higher heart rate in some people. Examples include sugary or high-carb foods in people with low blood sugar; high-salt foods in those with high blood pressure; or eating spicy foods that cause heartburn, which can result in a pounding heart. Usually, a fast heart rate after eating is not a cause for concern, but you should mention its occurrence to your doctor, especially if this happens repeatedly.

Types of Fast Heart Rate

Fast heart rates can occur in different parts of your heart. Doctors identify different types of fast heart rate, related to the location in which they occur. These include:

  • Atrial fibrillation, often referred to as afib: a rapid, irregular heartbeat caused by irregular electrical impulses in the atria, which are the upper chambers of your heart. Afib is the most common type of tachycardia.
  • Atrial flutter: A rapid, regular heartbeat, sometimes experienced by people who also suffer from atrial fibrillation
  • Sinus tachycardia: This occurs when your body responds to stimuli such as exercise or emotional distress with a normal increase in heart rate. 
  • Supraventricular tachycardia (SVT): A fast heartbeat that starts above the lower chambers of the heart
  • Ventricular tachycardia (VT): A rapid rate caused by abnormal electrical signals in the lower chambers of the heart, called ventricles. Episodes of VT that last longer than a few seconds can be life-threatening.
  • Ventricular fibrillation: A fast rate that occurs when rapid, irregular electrical impulses cause the lower chambers of your heart to quiver instead of pumping blood to your body. This type can be deadly and may require your heart to be restored to normal rhythm via electric shock to the heart.

Potential severe complications of fast heart rate depend on which type of tachycardia you have, how fast your heart is beating (some people experience heart rate of more than 400 beats per minute), how long your rapid heart rate lasts, and whether you have other heart conditions. Some of the more serious consequences are:

  • Frequent fainting or unconsciousness
  • Heart failure
  • Sudden death

Signs You Need Emergency Fast Heart Rate Treatment

Brief episodes of fast heart rate, such as palpitations that last only a second or two, generally aren’t a reason to worry, unless you also have a history of heart problems or disorders such as afib. You should still discuss them with your doctor, but you likely do not need to rush to the ER.

However, if you have tachycardia symptoms that include the following, seek emergency help (call 911):

  • Difficulty breathing
  • Extremely fast heart rate
  • Irregular heartbeat

The treatment you receive will depend on your symptoms and the type of heart disorder you have. If you have ventricular tachycardia along with other symptoms that your body is in distress, such as trouble breathing and chest pain, your emergency treatment can involve:

  • Cardiopulmonary resuscitation (CPR)
  • Cardioversion, which is electric shock that restores your heart to a normal beat
  • Intravenous medications

Your health provider may recommend treatment to prevent further episodes of rapid heartbeat, such as oral medications. Sometimes procedures may be needed. Two common ones are:

  • Radiofrequency ablation, a procedure that destroys the heart tissue causing abnormal beats
  • Implantation of a cardioverter defibrillator (ICD), a device that detects life-threatening rapid heartbeats and automatically sends an electric shock to your heart to restore normal rhythm

Another recommendation you might receive if you have a high resting heart rate (above 90 beats per minute) is to exercise more. This can improve your overall physical conditioning and can result in a lower resting heart rate. Slower resting heart rate, also referred to as a low pulse rate, in most cases is better than having a fast one. Higher resting heart rates have been associated with having atherosclerosis (hardening of the arteries) and an increased risk of dying from cardiovascular disease.

If you have concerns about your heart rate, you should discuss these with your physician to see what steps you should take for better heart health.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jun 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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