Do You Have a Slow or Racing Heartbeat?

What you need to know about bradycardia and tachycardia

Slow or Rapid Heartbeat-What You Need to Know

During our lives, we have a one in three chance of developing a heart rhythm abnormality. In cardiology, the field of electrophysiology focuses on heart rhythm disturbances—or heart arrhythmias as they are called. While the heart muscle may not be damaged, a heart arrhythmia can cause serious functional problems.

With a normal range of 60 to 100 beats per minute, on any given day, our hearts beat an average of 100,000 times. For a person living to the age of 78, that is about 3.3 billion heartbeats in a lifetime. A change in this normal heart rate is referred to broadly as bradycardia or tachycardia.

When the heartbeat is too slow, the condition is called bradycardia. Tachycardia exists when the heartbeat is too fast. These two arrhythmia conditions have different causes, symptoms and treatments.

“If you feel an irregular heart beat and you’re experiencing symptoms of dizziness, palpitations or passing out, then it is most likely one type of arrhythmia,” says Cleveland Clinic Cardiologist Walid Saliba, MD. “When this happens, you need to be evaluated by a physician right away.”

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About bradycardia, the slow beat

A slowed heart rate varies greatly from person to person. Bradycardia is defined as a heartbeat below 60 beats per minute, however, it does not necessarily need to be treated unless it is associated with symptoms. A rate that is too slow for a person will reduce the amount of blood and oxygen to vital organs, which results in various symptoms such as shortness of breath, a drop in blood pressure, extreme fatigue, decreased exercise capacity, dizziness and fainting.

Causes for bradycardia include:

  • degenerative disease of the electrical system of the heart that comes with age
  • electrolyte imbalances
  • hypothyroidism
  • side effects from blood pressure medications
  • coronary diseases that damage the electrical system of the heart

Treatments for bradycardia often focus on managing the underlying conditions that are causing the slow heart rate; sometimes a pacemaker will be implanted. “Many times a slow heart beat does not need to be treated,” says Dr. Saliba, “unless it is associated with ongoing symptoms.”

About tachycardia, the fast beat

Tachycardia is a rapid heart rate that is faster than 100 beats per minute, and it causes the heart to work too hard. This means that the heart does not have enough time to fill and that not enough blood is being pumped forward. This results in symptoms including palpitations, chest pain, dizziness and fainting. Sometimes patients have no symptoms aside from the rapid heart rate.

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Causes for tachycardia can be:

  • congenital abnormalities
  • heart disease (such as weakness of the heart muscle, heart failure or heart attack)
  • some types of lung diseases

It can also be caused by fever, dehydration, excessive caffeine (from energy drinks, etc.), substance abuse or a reaction to a medication.

Prior to any treatment, the doctor will look for underlying causes for the fast heart rate. Common treatments for tachycardia, include anti-arrhythmic medications to slow down the heart and cardioversion, which is an electric shock used to reset the normal rhythm of the heart.

Dr. Saliba stresses, “If you have fast or irregular heartbeats, you also will want to find out if you have a condition called atrial fibrillation—not just an arrhythmia. If so, you have a greater risk for a stroke and need to be treated.”

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  • John Reading


  • roverurboat

    My average heartbeat is under 60bpm. I run about 25 miles a week and have always attributed the slow heartbeat to the running……hope I’m right!

    • Ron Quandt

      You probably are right but have you discussed it with your physician and have you checked your oxygen levels on a regular basis?

  • A Austin

    I had a mild heart attack a week ago, 53 non-smoker, 6’5″ 230, lots of cardio, teach spin, and lots of yoga and pilates…..My resting rate is in the 50’s and blood pressure is 110/65. I say all of this because these are no guarantees of cardiovascular health. I had 100% blockage on one and had a stent. My issue is genetics and probably eating the wrong stuff in younger years, even though I was a national class athlete in cycling. Cardiograms showed no heart issue, just blood tests. An endocardio (ultrasound) did but an angiogram which is invasive was the best diagnosis. I only had the angiogram because they expected to install a stent (angioplasty)….Heart health is not just HR and BP, blood work for cholesterol, a stress test might be a good idea for the serious athlete over 40.

    • The_Beating_Edge_Team

      thanks for sharing your story. It is important to look at the full picture – to see if you are at risk – your family history is a big factor and if you have a strong family history you need to be more aggressive with managing risk factors. Also pay attention to symptoms – sometimes people think that they “just can’t do what they used to” but decrease in functional ability is also a sign of possible heart disease. Hope all is well A Austin. Take care. betsyRN

      • doodi

        I have a consistent resting heart rate of 56 bpm. I have had a stress test and echocardiograph which showed normal. Im a 51 yr old female. Should I persist with finding out the reason for the slower heart rate?

        • The_Beating_Edge_Team

          doodi – what does your doctor say? In some cases a slow heart rate, particularly if you are an athlete, may be normal for you. The most important thing for someone who has bradycardia, or slow heart rate is are you having symptoms? Bradycardia with symptoms would require treatment. Did your doctor give you advice when your tests came back? Were you having symptoms and that sent you to be evaluated? Those are important questions. Talk to your doctor if you have concerns. Here is a page from the AHA on bradycardia – betsyRN

  • Vincent Regan

    I have all that above a 72old man..low pulse of 33 but no. Problem…to eat better..Will that help at my age

    • The_Beating_Edge_Team

      If your pulse is actually 33 beats per minute – you should be evaluated by a cardiologist. betsyRN

  • Deni

    I am a 47 yr old female and it has been medically noted for at least 4 yrs that my heart rate is a little concerning: consistently 99-102, resting. No one has said what exactly I should do, if anything, and I am confused as to what this means. Any advice?

    • The_Beating_Edge_Team

      Deni – there are many reasons for fast heart rate (tachycardia) – you can start with your family doctor and then if that is not giving you the answers you need, you should see a cardiologist to evaluate any underlying issues that may be causing this.

  • Nordlys

    My average is 100. I’m shocked, I have high stamina, so I believed I was average.

    • The_Beating_Edge_Team

      Nordlys – if you are often over 100 at rest – you probably want to get it checked out. If there is no underlying cause and you are feeling well – they may not treat – but if you do have some reason they would want to treat it. Note that things such as dehydration, excessive caffeine (from energy drinks, etc.), smoking, alcohol, some medications may cause fast heart rate. betsyRN