Heart palpitations

Description

Heart palpitations (pal-pih-TAY-shuns) are the feelings of having a fast heartbeat, palpitations or pounding heart. Stress, exercise, medication or, rarely, a medical condition that can trigger.

Although heart palpitations can be worrisome, they are usually harmless. Rarely, the heart palpitations can be a symptom of a more serious heart condition, such as an irregular heart rhythm (arrhythmia), that might require treatment.

Symptoms

Heart palpitations can feel like the heart is:

  • Beating too fast
  • Flip-flop
  • Rapid fluttering
  • Strong
  • Skipping beats

Heart palpitations can be felt in the throat or neck, as well as the chest. Can occur during activity or at rest.

When to see a doctor

Palpitations that are rare and last only a couple of seconds usually does not need to be evaluated. If you have a history of heart disease, and have palpitations often occur or get worse, consult your health care provider. You may need to the heart of control tests, to see if the palpitations are caused by a more serious heart problem.

Seek emergency medical attention if you heart palpitations with:

  • Chest discomfort or pain
  • Fainting
  • Severe shortness of breath
  • Severe dizziness

Causes

Often, the cause of the palpitations of the heart can not be found. Common causes include:

  • Strong emotional responses, such as stress, anxiety, or panic attacks
  • Depression
  • The strenuous exercise
  • Stimulants, such as caffeine, nicotine, cocaine, amphetamines, and cold and cough medicines that contain pseudoephedrine
  • Fever
  • The hormonal changes associated with menstruation, pregnancy or menopause
  • Too much or too little thyroid hormone

Occasionally, the heart palpitations can be a sign of a serious problem, such as an irregular heart rhythm (arrhythmia).

Arrhythmias can cause a fast heart rate (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rate, or a combination of the three.

Risk factors

The risk factors for heart palpitations include:

  • Stress
  • Anxiety disorder or panic attack
  • Pregnancy
  • Certain medications that contain stimulants, such as cold or asthma medications
  • An overactive thyroid gland (hyperthyroidism)
  • Other heart problems such as irregular heartbeat, changes in the structure of the heart, heart attack prior or previous heart surgery

Complications

For palpitations caused by a heart condition, possible complications may include:

  • Fainting. If the heart beats rapidly, your blood pressure can drop, causing the person to faint. This is more likely in people with a heart problem, such as congenital heart disease or certain valve problems.
  • Cardiac arrest. Rarely, palpitations can be caused by life-threatening heartbeat problems and can cause the heart to stop beating effectively.
  • Stroke. If the palpitations are due to a condition in which the upper chambers of the heart quiver instead of beating properly (atrial fibrillation), blood can build up and cause the formation of clots. If a clot breaks loose, it can block an artery in the brain, causing a stroke.
  • Heart failure. Certain arrhythmias may reduce the pumping capacity of the heart. Sometimes, the speed control of an arrhythmia that is causing heart failure may improve the function of the heart.

Heart palpitations

Diagnosis

To diagnose heart palpitations, a health care provider will perform a physical exam and listen to your heart with a stethoscope. The exam may include looking for signs of medical conditions that can cause palpitations of the heart, such as a swelling of the thyroid gland. You will probably ask you questions about your medical history.

If your doctor thinks that the palpitations are caused by an irregular heartbeat or other heart disease, the evidence may include:

  • Electrocardiogram (ECG or EKG). This quick and painless test that measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. The wires connect the electrodes to a computer, which displays the results of the test. An electrocardiogram (ECG) may show if the heart beats too slowly, too fast, or not at all.
  • The Holter monitoring. This portable ECG device is worn by a day or more to record the heart's rate and rhythm during daily activities. It is used to detect the heart palpitations that are not found during an ECG test. Some personal devices, such as smartwatches, offer remote monitoring of the ECG. Ask your health care provider if this is an option for you.
  • Recording of events. If you do not have the irregular rhythms of the heart while you wear a Holter monitor, or if events occur less than once a week, your doctor may recommend a recorder of events. Press a button, when symptoms occur. An event recorder is typically used for up to 30 days or until you have an arrhythmia or symptoms.
  • The echocardiogram. This noninvasive test that uses sound waves to create moving pictures of your heart in motion. You can display blood flow and the structure of the problems with the heart.

Treatment

Unless the palpitations are caused by a disease of the heart, palpitations of the heart rarely require treatment. Instead, a health care provider may recommend taking measures to avoid the triggers that cause palpitations.

If the palpitations are caused by a disease of the heart, such as an irregular heart rhythm (arrhythmia), the treatment is focused on correcting the condition.

Self-care

The most appropriate way to treat palpitations at home is to avoid the triggers that cause the symptoms.

  • Reduce stress. Try relaxation techniques, such as meditation, yoga or deep breathing exercises.
  • Avoid stimulants. Caffeine, nicotine, some cold medicines and energy drinks can cause the heart to beat too fast, or irregular in shape.
  • Avoid illegal drugs. Certain drugs, such as cocaine and amphetamines, can cause heart palpitations.

Preparing for your appointment

If you have heart palpitations with severe shortness of breath, chest pain, or fainting, seek emergency medical attention.

If the palpitations are brief and there is no other worrisome signs or symptoms, make an appointment to see your health care provider. A health care provider can help determine if the palpitations are harmless or a symptom of a more serious heart condition. You may be referred to a doctor who specializes in heart conditions (cardiologist).

Here's some information to help you prepare for your appointment:

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet.

Make a list of:

  • Your symptoms, including any that seem unrelated to the palpitations of the heart, and when they began
  • Key personal information, including family history of heart disease, cardiac arrhythmias, stroke, high blood pressure or diabetes, as well as the major stresses or recent changes in your life
  • All the drugs, vitamins, and supplements you are taking, including dose
  • Questions to ask your health care provider

Have a friend or family member, if possible, to help you remember the information they give you.

For palpitations of the heart, basic questions to ask your health care provider include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • What should I do if I have symptoms return?
  • What tests are needed?
  • I need treatment and, if so, what?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Do you have brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • Do you always have palpitations or come and go?
  • Do the palpitations start and stop suddenly?
  • Do the palpitations seem to occur at the same time every day or during a certain activity?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you have other symptoms such as shortness of breath, chest pain, fainting, or dizziness during the episode?
  • Do you have a history of heart rhythm problems such as atrial fibrillation?

What you can do in the meantime

Before your appointment, you can try to improve your symptoms, avoiding stress, or activities that can cause palpitations. Some common triggers include:

  • Anxiety or panic attacks
  • Excess caffeine or alcohol
  • The use of drugs or supplements that contain stimulants, such as energy drinks or some cold medications
Symptoms and treatment of Heart palpitations