Tachycardia at night
If tachycardia occurs preferentially in a supine position, this may be associated with position-related pressure changes on receptors and nerve connections. The range of causes for simultaneous occurrence of both symptoms is broad and can be due to psychological triggers in addition to organ-specific diseases. If the tachycardia persists for a certain period of time while lying down, a medical examination is recommended.
Tachycardia as a reaction to a sudden physical strain or to a sudden onset of excitement or anxiety is usually a harmless response of the body to the new situation in the absence of further symptoms. If, however, tachycardia occurs frequently or without a recognizable cause, accompanied by other symptoms such as chest pain, trembling, dizziness and nausea, the tachycardia should be clarified by a physician in order to rule out serious organic causes and to detect possible diseases at an early stage. The doctor begins the diagnosis with a comprehensive anamnesis.
Questions about the type of tachycardia are particularly important: the medical history provides the doctor with a first impression of the patient’s symptoms and can make initial assumptions about the causes. During the physical examination, the doctor will focus on any signs of heart failure, congenital heart defects or high blood pressure. The lungs and thyroid gland are also closely examined.
The next step in the examination is the recording of a resting ECG, which is mainly evaluated with regard to a past heart attack, indications of heart failure or serious rhythm disturbances. In the exercise ECG, an ECG is recorded on the bicycle ergometer under physical exertion in order to detect tachycardia, which occurs only under physical stress. In the case of tachycardia that only occurs in phases, a long-term ECG can be recorded over 24-48 hours.
In any case, disturbances in the electrolyte balance and hyperthyroidism should be excluded by means of a blood sample to clarify tachycardia. If lung disease is suspected as the cause of tachycardia, a pulmonary function test and a blood gas analysis are performed. Serious rhythm disturbances, which occur only rarely, can be recorded by so-called event recorders (either outside the body or implanted).
If the episodes of tachycardia cannot be recorded, such an episode may possibly be triggered by the carotid pressure test or the tilt table test and recorded in the ECG. An invasive diagnosis is possible by means of an electrophysiological examination, which, depending on the cardiac arrhythmia detected, may also be a therapeutic procedure.
- Did it start suddenly or gradually?
- How often does it occur?
- How long does an episode of palpitations last?
- What accompanying symptoms (fainting, dizziness, chest pain, shortness of breath, etc.) occur during palpitations?
- Was there a particular triggering situation?
- Does the patient take medication regularly?
