Heart rate measures how many times your heart beats in one minute (bpm). It reflects the heart’s contractions, which pump blood throughout your body to deliver oxygen and remove carbon dioxide. While a fluctuating heart rate is normal, extreme or persistent deviations can signal a serious underlying health issue and indicate cardiovascular function.
Understanding Your Heart Rate
For most adults, a normal resting heart rate is 60 to 100 beats per minute. A lower resting heart rate often indicates a more efficient heart and better cardiovascular fitness, with highly trained athletes sometimes having rates as low as 40 to 60 bpm. To check your pulse, place two fingers on your wrist, between the bone and the tendon on the thumb side, or in the groove on the side of your neck next to your windpipe. Count the beats for 15 seconds and multiply by four to get your beats per minute.
Many factors can temporarily influence your heart rate. Physical activity, stress, and anxiety naturally cause your heart rate to increase. Stimulants like caffeine and nicotine can also elevate heart rate. Dehydration, fever, pain, certain medications, and changes in body position can impact your heart’s rhythm.
When a High Heart Rate Needs Emergency Care
A persistently high heart rate, known as tachycardia, is a resting heart rate above 100 beats per minute for adults. While temporary increases are normal due to exercise or stress, a sustained rate above 120 beats per minute, or a sudden jump, can be concerning. Seek emergency medical attention if a rapid heart rate is accompanied by specific symptoms.
These include:
- Chest pain or discomfort (can indicate a serious cardiac event)
- Shortness of breath
- Dizziness or lightheadedness
- Fainting or near-fainting spells
- Palpitations (a racing or pounding sensation in the chest)
- Sudden weakness
These symptoms suggest the heart may not be effectively pumping blood, potentially leading to insufficient oxygen supply to the body’s organs.
When a Low Heart Rate Needs Emergency Care
A low heart rate, termed bradycardia, is a resting heart rate below 60 beats per minute. While a low heart rate can be normal for well-conditioned athletes, for others, a persistently slow rate, especially below 40 to 50 beats per minute at rest, warrants attention. When bradycardia occurs with noticeable symptoms, it can signal an underlying health problem.
Symptoms that necessitate an immediate emergency room visit include:
- Dizziness or lightheadedness (can occur if the brain is not receiving enough oxygenated blood)
- Fainting or near-fainting spells
- Persistent fatigue
- Shortness of breath
- Chest pain
- Confusion or memory problems (may arise from reduced blood flow to the brain)
These symptoms, with a low heart rate, should prompt emergency care.
What to Expect at the Emergency Room
Upon arrival at the emergency room for heart rate concerns, medical staff will conduct an initial assessment. This involves checking your vital signs, including heart rate and blood pressure. You will be asked about your current symptoms, their duration, and your medical history, including pre-existing heart conditions or medications.
An electrocardiogram (EKG or ECG) is a standard test to record your heart’s electrical activity and assess its rhythm and rate. This quick, non-invasive test helps identify abnormalities in the heart’s electrical signals. Depending on initial findings, further tests may be ordered, such as blood tests for electrolyte imbalances, thyroid function, or cardiac enzymes. Imaging studies might also be considered to evaluate the heart’s structure and function.