Guide to Heart Palpitations

Is your heart skipping a beat? Heart palpitations are the awareness that your heart is beating. Here's what you should know about keeping your heart healthy.


Heart palpitations are the awareness that your heart is beating. Usually the feeling is that your heart is beating abnormally: either skipping a beat, fluttering, beating too hard or too fast.

The feelings can occur in your chest, neck, or throat and can occur during activity or rest. Most people have felt palpitations. They are common and usually harmless, but they can be a sign of serious heart trouble.

There may be a problem if in addition to palpitations you also:

  • feel dizzy or confused
  • feel lightheaded or faint
  • have difficulty breathing or feel short of breath
  • feel pain, pressure, or tightness in your chest, jaw, or arm
  • have unusual sweating.

Many things can cause heart palpitations. You can even be aware of your heart beat when it is actually beating normally. In most cases, heart palpitations are not a sign of underlying disease. However, in some cases they can be a sign of serious heart problems.

Several things can trigger palpitations, including:

  • strong emotions
  • anxiety
  • physical activity
  • caffeine
  • alcohol
  • nicotine
  • certain medicines (such as pseudoephedrine)
  • hormonal changes
  • some medical conditions, such as anemia

These things all tend to make the heart beast faster and/or stronger than normal but despite the sensation, the heart is still working normally.

Sometimes palpitations can be symptoms of arrhythmias, which are problems with the speed or rhythm of the heartbeat. Arrhythmias may themselves be signs of underlying heart dysfunction such as coronary artery disease, heart attack, heart failure, or heart valve problems. Most people with heart palpitations do not have arrhythmias, but if you experience palpitations you should see your doctor to be checked out.

Everyone experiences heart palpitations at some time or another. The risk of palpitations tends to increase with age.

The following factors can increase your risk of heart palpitations that are not associated with an underlying heart arrhythmia:

  • anxiety
  • stress
  • panic attacks
  • recent strenuous exercise
  • caffeine
  • nicotine
  • fever
  • hormone changes associated with menstruation, pregnancy, or menopause
  • certain medications, such as pseudoephedrine

Also, there are factors that can increase your risk of having palpitations that are related to underlying problems with heart rhythm, including:

  • Heart disease or risk factors for heart disease such as obesity and high cholesterol.
  • History of heart attack.
  • Heart failure, heart valve problems, or heart muscle problems.
  • Abnormal electrolyte levels (levels of ions in your blood such as sodium and potassium).

Heart palpitations are a subjective feeling of the heart beating. You have them when you feel them. What is more important is finding out if those heart palpitations are harmless or if they are the symptoms of an underlying heart arrhythmia. See the doctor right away if you experience heart palpitations.

 When attempting to determine the cause of your palpitations the doctor will start by taking your medical history and asking questions about your recent personal history (such as whether you have taken any drugs recently), then he or she will likely conduct a physical examination. The doctor may also order some tests to check your heart function.

The most basic test of heart function is an ECG (electrocardiogram). This involves placing electrodes on your chest and recording the electrical activity of the heart. This test can detect arrhythmias and may also pinpoint the source of a problem within the heart. This test can help determine if you have heart problems but it cannot rule out heart problems entirely.

If the doctor suspects there is an underlying heart problem, he or she may order further tests including blood tests or a heart monitor test that records your heart's activity for one to two days. If necessary, the doctor may also order an echocardiogram that uses sound waves to get an image of the heart in action, or a stress test that looks at your heart's activity under physical duress.

Heart palpitations are a subjective feeling of the heart beating. You have them when you feel them. What is more important is finding out if those heart palpitations are harmless or if they are the symptoms of an underlying heart arrhythmia. See the doctor right away if you experience heart palpitations.

What to expect at the doctor: When attempting to determine the cause of your palpitations, the doctor will start by taking your medical history and asking questions about your recent personal history (such as whether you have taken any drugs recently), then she will likely conduct a physical examination. The doctor may also order some tests to check your heart function.

The most basic test of heart function is an ECG (electrocardiogram). This involves placing electrodes on your chest and recording the electrical activity of the heart. This test can detect arrhythmias and may also pinpoint the source of a problem within the heart. This test can help determine if you have heart problems but it cannot rule out heart problems entirely.

If the doctor suspects there is an underlying heart problem, she may order further tests including blood tests or a heart monitor test that records your heart's activity for one to two days. If necessary, the doctor may also order an echocardiogram that uses sound waves to get an image of the heart in action, or a stress test that looks at your heart's activity under physical duress.

If you have a medical condition that is causing your palpitations, the doctor can help treat the problem and your palpitations should resolve. If you are taking a medication that tends to cause palpitations as a side effect, the doctor can suggest an alternative medicine for you to take.

If your palpitations are due to a heart arrhythmia, you and the doctor can decide on a strategy for treating the arrhythmia or the underlying heart disease that may be causing it.

People can reduce or prevent palpitations by treating any related medical conditions and by avoiding the things that trigger palpitations.

For example:

  • Reduce anxiety and stress.
  • Avoid stimulants, such as caffeine, nicotine, alcohol, or amphetamines and illegal ones such as cocaine.
  • Avoid medicines that act as stimulants, such as cough and cold medicines that contain pseudoephedrine and certain herbal and nutritional supplements.

Heart palpitations are often harmless, but if you start experiencing them for the first time, you should see the doctor and make sure they are not a symptom of an underlying heart problem. Especially if in addition to the palpitations you also feel dizzy or short of breath, have chest pain, or you feel faint you should see a doctor right away.

If you have already seen a doctor about your palpitations and have been told that you do not have underlying heart problems, you should see the doctor again if your palpitations increase in frequency or if they occur with the symptoms mentioned above.


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