What are heart palpitations?
Heart palpitations are a feeling like your heart is racing, pounding, fluttering, or like you have extra or missed heartbeats. You can feel palpitations in your chest, throat or neck.
Palpitations can happen at any time, even if you are resting or doing normal activities. Although they may be startling, palpitations are not usually serious or harmful, but they can be related to an abnormal heart rhythm.
What causes heart palpitations?
Heart palpitations can be caused by:
- Emotions, such as anxiety, stress, fear and panic.
- Exercise.
- Pregnancy.
- Caffeine.
- Medical conditions such as an overactive thyroid; low levels of sugar, potassium, oxygen or carbon dioxide in your blood; fever; anemia; dehydration; blood loss and shock.
- Medications such as asthma inhalers and decongestants, beta blockers (taken for high blood pressure or heart disease), thyroid and antiarrhythmic medications, some cough/cold medicines and some herbal and nutritional supplements.
- Illegal drugs such as cocaine and amphetamines (speed).
- Nicotine.
- Sometimes the cause is not known.
Palpitations are more likely to be related to an abnormal heart rhythm if you have:
- Significant risk factors for heart disease.
- Heart disease.
- An abnormal heart valve.
Are palpitations a symptom of a more serious health problem?
Palpitations may be a sign of a more serious health problem if you also:
- Feel dizzy, confused or lightheaded.
- Have trouble breathing.
- Pass out when you have palpitations.
Call 911 right away if you have these symptoms or if you have pain, pressure or tightness in your chest, neck, jaw, arm(s), or upper back; shortness of breath; unusual sweating; or symptoms that are new or get worse.
How are palpitations diagnosed?
Keep track of your palpitations. Note when they happen, how long they last, how you feel and what you are doing when they start. Bring this log to your appointment.
Your doctor will review this information along with your medical history, symptoms, diet and the medications and herbal products you take. Your doctor will also listen to your heart and lungs.
You may need tests, such as blood and urine tests, electrocardiogram (ECG/EKG), stress test, chest X-ray and echocardiogram (heart ultrasound). You may need to wear a monitor after you go home so your doctor can get more information about your heart and symptoms.
Other tests to check for a heart problem include an electrophysiology study and cardiac catheterization. You may also need to see an electrophysiologist — a doctor that specializes in abnormal heart rhythms.
What treatments are available for patients with heart palpitations?
The best type of treatment for you depends on what causes your palpitations. You may not need any treatment. If the palpitations are related to certain foods or activities, you should avoid those triggers. If you have heart disease or an abnormal heart rhythm, you may need medication, a procedure, surgery or a device to correct the problem. It is important to keep all follow-up appointments with your doctor.
If your palpitations get worse or suddenly happen more often, call your doctor.
What can I do to prevent palpitations?
Depending on the cause of your palpitations, these tips can help you have them less often:
- Reduce your stress level using deep-breathing and/or relaxation exercises, yoga, tai chi, guided imagery or biofeedback techniques.
- Avoid or limit the amount of alcohol you drink.
- Avoid or limit the amount of caffeine in your diet.
- Do not smoke or use tobacco/nicotine products
- Exercise on a regular basis. Before you start, ask your doctor which exercise programs are good for you.
- Avoid foods and activities that trigger palpitations.
- Control your blood pressure and cholesterol levels.
