Heart Palpitations
Heart palpitations are a feeling of having a fast-beating, racing, pounding or fluttering heart. You may notice heart palpitations in your chest, throat, or neck. Although heart palpitations can be frightening or worrisome, they are generally harmless and often go away on their own.
Heart palpitations are usually triggered by stress, exercise, medication or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant. In rare cases, they can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.
Symptoms
Heart palpitations can occur when you’re active or at rest. They feel like your heart is:
- Beating too fast
- Skipping beats
- Fluttering rapidly
- Pounding
- Flip-flopping
When to see a doctor
Infrequent palpitations that last only a few seconds usually don't need to be evaluated. If you have a history of heart disease and have palpitations that occur frequently or worsen, consult your doctor. In certain cases, testing (such as an ECG, holter monitor, blood work, echocardiogram or chest x-ray may be ordered). Seek emergency medical attention when heart palpitations are accompanied by:
- Fainting
- Pain, pressure, or tightness in the chest, neck, jaw, arms, or upper back
- Severe shortness of breath
- Severe dizziness
- Confusion
Causes
Usually, palpitations are either related to your heart or the cause is unknown. Common causes can include:
- Strenuous exercise
- Strong emotional responses, such as stress, anxiety or panic attacks
- Depression
- Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
- Fever
- Hormone changes associated with menstruation, pregnancy or menopause
- Too much or too little thyroid hormone
- Occasionally heart palpitations can be a sign of a serious problem, such as an overactive thyroid gland (hyperthyroidism) or an abnormal heart rhythm (arrhythmia).
Risk factors
You might be at risk of developing palpitations if you:
- Are highly stressed
- Have an anxiety disorder or have regular panic attacks
- Are pregnant
- Take medicines that contain stimulants, such as some cold or asthma medications
- Have an overactive thyroid gland (hyperthyroidism)
- Have other heart problems, such as an arrhythmia, a heart defect, coronary artery disease, prior heart attack or previous heart surgery.
Treatment
Unless your physician finds that you have a heart condition, heart palpitations rarely require treatment. If your physician doesn’t find a cause, they may advise you to avoid the things that might trigger the palpitations. Strategies may include:
- Reduce anxiety and stress
- Relaxation exercises
- Cut out certain foods, beverages, and other substances, such as alcohol, nicotine, caffeine or illegal drugs.
- Avoid medications that act as stimulants, such as cough and cold medications or certain herbal and nutritional supplements
If your palpitations are caused by a heart problem, such as an arrhythmia, medications or procedures may be recommended.