Should I worry about my fast pulse?

Published: August, 2015

Q. My pulse is usually on the fast side. Does a high heart rate mean I have a problem with my heart?

A. In otherwise healthy people, I don't usually worry about the heart rate unless it is consistently above 100 beats per minute at rest. Heart rates that are consistently above 100, even when the patient is sitting quietly, can sometimes be caused by an abnormal heart rhythm. A high heart rate can also mean the heart muscle is weakened by a virus or some other problem that forces it to beat more often to pump enough blood to the rest of the body.

Usually, though, a high heart beat is not due to heart disease, because a wide variety of noncardiac factors can speed the heart rate. These include fever, a low red blood cell count (anemia), an overactive thyroid, or overuse of caffeine or stimulants like some over-the-counter decongestants. The list goes on, and includes anxiety and poor physical conditioning.

Ask your doctor to check your pulse, and whether he or she thinks it is too high. It may help if you learn how to take your pulse, and keep a diary. If your heart rate is on the high side of normal, and there are no signs of anything serious going on, your doctor may suggest that you increase your daily physical activity. Getting in better physical condition will tend to slow the resting heart rate; it's not unusual for runners to have very low heart rates.

— Richard Lee, M.D. Former Associate Editor, Harvard Heart Letter

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