When a person has heart palpitations, they may notice that their heartbeat does not feel right. Often, it is not serious, but it can indicate a condition that needs medical attention.
People are not usually aware of their heartbeat, but sometimes, it comes to their notice. This may be because their heart is pounding too hard, too fast, too slow, or irregularly.
This article explores the causes of heart palpitations, how to test for them, and some treatment options for them.
People experience heart palpitations in different ways. Some common descriptions include:
- beating harder, faster, or irregularly
A person may feel a heart palpitation in the neck, throat, or chest. They may even feel them in the ear if they are lying down.
For some people, palpitations last for only a few seconds, while other people may experience them for minutes or hours at a time.
In many cases, palpitations are annoying but not serious. However, they can be a symptom of arrhythmia, and they may also be a warning sign of cardiac arrest.
For this reason, it is a good idea for people who experience heart palpitations to seek medical advice.
However, they can also indicate an underlying heart problem.
Palpitations can stem from a wide range of heart conditions. They are often linked to abnormal heart rhythms, or arrhythmia. However, this can also be a sign of an underlying condition.
A person may experience palpitations with the following:
- coronary artery disease
- heart valve problems, especially relating to the mitral valve
- structural heart problems that are present from birth
- cardiomyopathy, wherein the heart becomes enlarged
- ventricular tachycardia
- atrial fibrillation
It may also be a warning sign of heart failure or a heart attack, both of which can result from a range of structural and other issues.
Emotional factors that can trigger heart palpitations include:
- insomnia or lack of sleep
Certain medications can also trigger heart palpitations. These include:
- asthma inhalers
- thyroid hormone replacement medications
- antiarrhythmic medications
- some antifungal therapies
- some cough and cold medications
- some herbal or nutritional supplements
Certain underlying medical conditions may be the cause of heart palpitations. These include:
- food poisoning
- low blood sugar
- low potassium
- low magnesium
- high temperature and fever
- loss of blood
- postural or orthostatic hypotension
- low oxygen levels in the blood
- Paget’s disease
- Wolff-Parkinson-White syndrome
Lifestyle factors that may cause heart palpitations include:
- caffeine consumption (from tea, coffee, or energy drinks)
- alcohol consumption
- tobacco smoking
- strenuous exercise
- recreational drug use (cannabis, cocaine, heroin, ecstasy, or amphetamines)
- rich or spicy food consumption
Hormonal changes are another possible cause. Changes in hormone levels may result from:
- menstrual periods
- thyroid problems
Many cases of heart palpitations are harmless. However, if they are a sign of an underlying heart condition, there can be serious complications.
These complications may include:
- fainting due to a fast heartbeat, wherein blood pressure simultaneously drops to a very low level
- stroke, which can lead to neurological damage
- supraventricular tachycardia, in which a rapid heart rate typically starts and ends abruptly
- atrial fibrillation, which can indicate ischemic stroke or underlying heart disease
- ventricular tachycardia (VT), wherein the heart rate reaches more than 100 beats per minute and is out of sync with the atria (upper heart chambers)
- ventricular fibrillation, which can result if VT goes untreated and which can be fatal
Heart palpitations can also be a symptom of heart failure, and they may precede cardiac arrest.
Heart palpitations usually pass quickly and are not serious, but it is a good idea to speak with a doctor if they occur.
In 2011, experts advised healthcare professionals to assess people for cardiovascular problems if they seek advice for palpitations.
Anyone with the following should contact their doctor if palpitations occur:
- a history of heart problems
- palpitations that worsen or do not improve
- other symptoms, such as chest pain
- other health concerns
Palpitations are unlikely to occur at the doctor’s office, but keeping a log of the following points may help with diagnosis:
- what the palpitations feel like
- how often they happen
- when they happen
Being able to answer some of the following questions may also help the doctor:
- During a palpitation episode, is the heart rate too fast or too slow, and is the rhythm regular or irregular?
- Is there lightheadedness, dizziness, shortness of breath, or chest pain?
- Do the palpitations tend to occur when a person is doing a particular activity? Is there a pattern?
- Do the palpitations start and stop suddenly or fade in and out?
The doctor will likely:
- ask about symptoms
- carry out a physical exam
- look at the individual’s medical history
- do a test using a 12-lead electrocardiogram (ECG)
An ECG measures heart rate and rhythm parameters through electrical tracing.
Depending on the symptoms, the doctor may also do blood tests, an exercise stress test, and other investigations, such as asking the person to wear an arrhythmia monitor at home.
They may also refer the person to a cardiologist.
Not everyone with heart palpitations will need treatment. If they do, it will depend on the person’s symptoms and the cause and amount of palpitations they are experiencing.
If a person starts to have palpitations while taking certain medications, a doctor may recommend an alternative.
If tests reveal an underlying heart problem, the following treatments may help:
The doctor may prescribe antiarrhythmic drugs, such as beta-blockers or non-dihydropyridine calcium channel blocker therapy.
Beta-blockers slow the heart rate and reduce blood pressure.
A medical procedure
The following interventions may help manage severe heart palpitations:
During catheter ablation surgery, a cardiologist will thread an ablation device into the heart through a catheter that passes through a deep vein in the groin, neck, or chest.
The device causes scars to form over faulty electrical tracts in the heart. This can help correct the way in which electrical impulses travel through the heart.
This procedure involves sending an electrical shock into the chest wall to try to stabilize a person’s heart rhythm and rate. A doctor may choose this therapy to “reset” the electrical rhythm of the heart.
Implantable pacemaker or defibrillator placement
A pacemaker is a permanent cardiac device that monitors and treats electrical conditions of the heart.
Some people experience regular palpitations, which may be bothersome. To reduce these, a person can try the following:
- Find a comfortable position and relax.
- Deep breathing techniques may help.
- Blowing on the thumb or initiating the Valsalva maneuver can also help stop palpitations.
- Try to avoid panic, as this can worsen symptoms.
- It may help to loosen any tight clothing.
- Magnesium supplementation can also be useful. People can discuss this with a doctor.
Often, lifestyle strategies can help reduce or stop non-serious palpitations. For example, people should try to reduce or avoid the following:
- any medications that may trigger palpitations
Other tips include:
- following a healthful diet
- getting enough sleep
- getting regular exercise
- doing yoga, meditation, breathing exercises, or tai chi to help manage stress
- avoiding known triggers or learning new ways to approach them
These measures may also help reduce the risk of heart disease.
Many people experience heart palpitations from time to time. They can be non-severe, and some people will not need treatment. However, they can also indicate an underlying health condition.
For this reason, people should seek help if the palpitations occur unexpectedly or often, if they have an existing heart condition, or if they have other symptoms.