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What causes a high resting heart rate? Related conditions and treatments

Medically reviewed by Chad Shaffer, MD
Physician
Updated May. 3, 2024  •  Published Oct. 31, 2023
Fact Checked
What causes a high resting heart rate?
In this article:

Overview: What does a high resting heart rate feel like?

The normal resting heart rate is between 60 and 100 beats per minute (bpm). When people engage in physical activity, the heart beats faster because the body needs more oxygen. Healthcare professionals call this “sinus tachycardia”: the heart beats fast (“tachycardia”) because the heart’s natural pacemaker (the sinus node) sends electrical signals to the heart muscle more rapidly. However, people may sometimes have heart rates above 100 bpm while at rest. That’s not normal. There are many reasons for a fast heart rate, even at rest. It may be the heart, but in many cases, it’s not. Some causes are relatively harmless, like a panic attack. Some require medical evaluation. Some are medical emergencies. A fast heartbeat isn’t the only sign that the heart is beating too fast, though it’s often the most obvious symptom. People whose hearts are beating too fast may also feel heart palpitations or chest pain. They may also feel lightheaded, tired, short of breath, or dizzy. The presence of other symptoms is usually a sign that medical help is needed right away.

RELATED: What’s a normal heart rate?

Key takeaways:

  • A high resting heart rate is a common symptom that may be caused by stress, anxiety, panic, dehydration, electrolyte abnormalities, heart rhythm abnormalities, heart problems, respiratory problems, pregnancy, hyperthyroidism, high blood sugar, bleeding, anemia, low blood pressure, shock, sepsis, certain types of cancer, drug withdrawal, pain, and medication side effects.

  • Typically, a high resting heart rate does not require immediate medical attention unless there are other symptoms like fever, dizziness, weakness, bleeding, shortness of breath, difficulty breathing, palpitations, or chest pain.

  • A high resting heart rate generally requires treatment and will resolve with treatment within a variable timeline, depending on the cause.

  • Treatments for a high resting heart rate vary by cause. 

  • Causes of a high resting heart rate might be managed with relaxation techniques, vagal maneuvers, adequate hydration, electrolyte intake, and avoiding stimulants.

  • Save on prescriptions for causes of a high resting heart rate with a SingleCare prescription discount card.

What causes a high resting heart rate?

The most common type of high resting heart rate is sinus tachycardia. This is a regular heart rhythm, but it’s been sped up to 100 bpm or higher. Everyone can experience sinus tachycardia when exercising, working hard, or being frightened. They can even experience it at rest for a few minutes after they’ve finished exercising or if they’re sitting down when they get frightened. Some high resting heart causes are benign and easily understood. Sometimes a high resting heart rate is due to an underlying medical condition that may require treatment.

Some types of tachycardia are due to heart rhythm abnormalities. These are called arrhythmias and include serious and life-threatening medical conditions such as atrial fibrillation (AFib) or supraventricular tachycardia (SVT). These types of tachycardia cause extremely fast heartbeats, highly irregular heart rhythms, and other severe and life-threatening symptoms. The heart may feel like it’s beating fast, but most people experience fluttering or pounding. These aren’t normal heartbeats that are going fast. They’re chaotic heart rhythms. They are caused by irregular electrical signaling in the heart's upper chambers (atria) or lower chambers (ventricles).

Sinus tachycardia has several causes. Benign causes of high resting heart rate include:

Temporary medical conditions that can cause sinus tachycardia include:

  • Dehydration

  • Electrolyte imbalances

  • High blood sugar (hyperglycemia)

Other medical conditions that can cause sinus tachycardia include:

Serious and even life-threatening medical conditions that cause sinus tachycardia include:

  • Heart infection (myocarditis)

  • Heart muscle damage (cardiomyopathy) associated with heart failure or heart attack

  • Heart disease

  • Pulmonary embolism (a blood clot in the arteries of the lung)

  • Lung disease

  • Insufficient oxygen (hypoxia)

  • Severe dehydration

  • Severe electrolyte imbalances

  • Very low blood pressure

  • Shock

  • Sepsis

  • Bleeding

Finally, some medications could cause rapid heartbeats as a side effect. These include:

Poisons such as carbon monoxide are also causes of a high resting heart rate. 

In rare cases, there’s no identifiable cause for a high resting heart rate. Clinicians may diagnose some of those cases as “inappropriate sinus tachycardia.” It is most common in young females who may not have heart health risk factors such as high blood pressure, diabetes, sleep apnea, high cholesterol, alcohol abuse, obesity, or heart disease.

RELATED: Here’s what actually happens when your heart skips a beat

Should I be worried about a high resting heart rate?

Tell a healthcare provider about any unusual heart symptoms that you experience. That includes any episodes with a high resting heart rate when there seems to be no reason. It may not be serious, but a healthcare professional should determine this. Suppose the cause of a high resting heart rate is a heart problem that goes untreated. In that case, complications of a persistently high resting heart rate or the underlying condition can include reduced heart function, organ damage, organ failure, cardiac arrest, and death.

Get immediate medical attention if a high resting heart rate is accompanied by chest pain, shortness of breath, difficulty breathing, lightheadedness, or palpitations. These are signs that something may be wrong with the heart. Immediate medical attention is also needed if there are symptoms such as high fever, changes in mental status, dizziness, unconsciousness, bleeding, or extensive bruising. These are signs of other serious medical conditions that may be causing a high resting heart rate. Emergency treatment is also needed if the heart does not slow down but continues to beat fast. 

RELATED: 15 signs of heart problems worth worrying about

How is the cause of a high resting heart rate diagnosed?

If the situation isn’t life-threatening, a clinician typically starts with a physical examination and medical history. If there is a high resting heart rate, it will be immediately spotted when taking a pulse rate. Don’t be surprised if the heart is beating normally when examined by a healthcare provider. The clinician will still listen to the heart through a stethoscope for unusual noises. 

In a medical history, the clinician will want to know:

  • Have you had heart symptoms before?

  • What was happening before the heart started beating fast?

  • What medications are you taking?

  • Do you use caffeine or nicotine products?

  • Are you using illegal drugs?

  • What illnesses do you have?

The next order of business is to perform tests to determine how well the heart is beating and identify any specific problems with the heart. These tests will include:

  • An electrocardiogram (EKG) to look at the heart’s rhythm

  • If the heart is not currently beating fast, the clinician may send the person home with a device called a Holter monitor to continuously measure the heart’s rhythm

  • An echocardiogram to examine how the heart beats in real time

  • A chest X-ray to identify heart problems, lung issues, or infections

  • Pulse oximetry to measure the oxygenation of the blood

  • Blood tests for blood cell counts, lactic acid, blood sugar, electrolytes, arterial blood gasses, and blood clots

How long does a high resting heart rate last?

Depending on the cause, a high resting heart rate can last seconds, minutes, hours, or days. It may happen once and then never happen again. On the other hand, people might have repeated episodes. These recurrent episodes may vary in frequency. They might happen once or twice a year. Some people might experience at-rest tachycardia several times a day. The longer an episode lasts or the more often episodes repeat, the more urgent it is to see a doctor.

How to stop a high resting heart rate

Healthcare professionals treat high heart rates by treating the cause. Appropriate treatment can rapidly resolve many causes, such as high blood sugar, dehydration, and electrolyte imbalances. Other causes, such as anxiety or panic disorder, may take weeks or months of treatment before high heart rate episodes abate. Some causes, such as heart problems, sepsis, or shock, may require emergency treatment. If there’s a diagnosable cause, healthcare professionals are unlikely just to treat the fast heartbeats.

However, if inappropriate sinus tachycardia is diagnosed, the healthcare professional will know how to treat this cause of a high resting heart rate. They may prescribe medications called negative chronotropes to slow down the heart. These include beta-blockers, calcium channel blockers, and HCN channel blockers. If drugs don’t work, a cardiologist may use a minimally-invasive catheter ablation surgery to slightly alter the function of the heart’s pacemaker.

Emergency treatments such as cardioversion and defibrillation are used for fast heartbeats due to abnormal heart rhythms, not due to a normal but fast heartbeat.

Living with a high resting heart rate 

In rare cases, some people may have a high resting heart rate with no identifiable cause. In those cases, clinicians can’t fix the problem but can help slow down the heart with medications or ablation surgery. However, some lifestyle changes can help reduce the heart rate:

  • Take the medications as instructed

  • Avoid caffeine, nicotine, and other stimulants

  • Be physically active

  • Eat a heart-healthy diet

  • Lose weight and maintain a healthy weight

  • Practice relaxation techniques

  • Drink fluids to remain adequately hydrated

  • Get enough electrolytes but not too much

  • Use Valsalva maneuvers or other types of vagal maneuvers to reduce fast heart rhythms if advised by your healthcare provider

RELATED: 7 foods to avoid if you have heart palpitations

Most importantly, get medical help

Heart symptoms such as a high resting heart rate should always be brought to the attention of a doctor or other healthcare provider, even if they only last for a brief time and don’t recur. They don’t always require immediate treatment, but a healthcare professional will know if the symptoms require further examination. If a high resting heart rate persists for a long time, keeps happening repeatedly, or if there are other symptoms, seek medical care immediately. There is a chance that the underlying cause is a heart problem or another medical condition that requires treatment. People already diagnosed with a heart condition who experience racing heartbeats while at rest should call a doctor.

What’s next? Additional resources for people with a high resting heart rate

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Chad Shaffer, MD
Physician

Chad Shaffer, MD, earned his medical doctorate from Penn State University and completed a combined Internal Medicine and Pediatrics residency at the University of Pittsburgh Medical Center and Children’s Hospital of Pittsburgh. He is board certified by the American Board of Internal Medicine and the American Board of Pediatrics. He has provided full-service primary care to all ages for over 15 years, building a practice from start up to over 3,000 patients. His passion is educating patients on their health and treatment, so they can make well-informed decisions.

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