Heart rate 133 on an adult - what does it mean?

Where 133 bpm sits on the adult scale

What a resting pulse of 133 means

If you just climbed stairs, exercised or are very anxious, a pulse of 133 can be a normal response and should fall within minutes. A fast rate that persists at rest can come from fever, dehydration, blood loss or anemia, an overactive thyroid, or a heart rhythm disorder such as atrial fibrillation, atrial flutter or supraventricular tachycardia (SVT).

An irregular pulse at this speed is a typical sign of atrial fibrillation, which raises stroke risk and should always be evaluated.

Ranges apply to adults and children aged 10 and older, measured at rest (American Heart Association). By the numbers: at 133 bpm the heart beats about every 0.45 seconds — roughly 191,520 beats a day.

Known thyroid disease and a pulse of 133: crisis or flare?

An overactive thyroid commonly lifts the resting pulse into the 90s or low 100s, sometimes higher, and the change builds over weeks. Thyroid storm is something else: a rare, sudden worsening in which thyroid hormone effects run out of control. It is a medical emergency. A resting rate of 133 can occur in both situations, so the number alone does not decide which one you are dealing with. What surrounds it does.

Side by side: the usual overactive thyroid and a storm

Ordinary hyperthyroidism tends to bring:

• a fast pulse that has crept up over weeks or months;
• weight loss, feeling hot, sweating, trembling hands;
• restlessness or poor sleep, but clear thinking;
• the ability to carry on with daily life, if uncomfortably.

Thyroid storm adds features that point to the whole body being overwhelmed:

• a high fever;
• marked agitation, confusion, delirium or unusual drowsiness;
• vomiting, diarrhea or belly pain;
• yellowing of the skin or eyes;
• breathlessness, swollen legs or other signs that the heart is failing to keep up;
• often a very fast heart rate, sometimes with atrial fibrillation.

A storm rarely comes out of nowhere. It usually follows a trigger in someone whose thyroid is already overactive, often not yet diagnosed or not well controlled. Recognised triggers include an infection, surgery, injury, childbirth, suddenly stopping anti-thyroid tablets, and a large dose of iodine, for example from contrast dye used in scans.

Which path to take

If you have a known overactive thyroid and a pulse of 133 together with fever, confusion, vomiting or breathlessness, call 911. Hospitals treat a storm in intensive care with several medicines at once, including drugs to block hormone production and to slow the heart, plus treatment of the trigger.

If none of those signs are present and you feel much as usual apart from the racing heart, the situation is still not one to sit on. A resting 133 that does not settle within ten to fifteen minutes calls for same-day medical advice. Thyroid levels may have risen, a dose may need changing, or the cause may be something other than the thyroid. Bring a list of your medicines and recent blood test results. The normal adult heart rate page shows the range your doctor will aim to bring you back to.

For a reliable resting value, sit quietly for five minutes first and average a few mornings: Resting Heart Rate: What It Says About Your Health. You can also measure by tapping along on the start page.

Nearby values

• 128 bpm
• 129 bpm
• 130 bpm
• 131 bpm
• 132 bpm
• 134 bpm
• 135 bpm
• 136 bpm
• 137 bpm
• 138 bpm

Measured on a child instead? See heart rate 133 in a child.

Sources: American Heart Association: All About Heart Rate · MedlinePlus: Pulse · ACSM position stand on exercise intensity (2011)

This page explains a single reading in general terms. It is not a diagnosis. Heart rate alone cannot tell whether the rhythm is regular or whether the heart is healthy — if you are worried, talk to a doctor.