Heart palpitations
Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing
Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.
You may:
- Have an unpleasant awareness of your own heartbeat
- Feel like your heart skipped or stopped beats
The heart's rhythm may be normal or abnormal when you have palpitations.
Considerations
Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise routinely or take medicines that slow the heart.
If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat is known as extrasystole .
Extrasystole
Ectopic heartbeats are small changes in a heartbeat that is otherwise normal. These changes lead to extra or skipped heartbeats. Often there is not...
Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm ( arrhythmia ) may be more serious.
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
The following conditions make you more likely to have an abnormal heart rhythm:
- Known heart disease at the time the palpitations begin
- Significant risk factors for heart disease
- An abnormal heart valve
- An electrolyte abnormality in your blood -- for example, a low potassium level
Causes
Heart palpitations can be due to:
- Anxiety, stress, panic attack, or fear
- Caffeine intake
- Nicotine intake
- Cocaine or other illegal drugs
- Diet pills
- Exercise
- Fever
However, some palpitations are due to an abnormal heart rhythm, which may be caused by:
- Heart disease
- Abnormal heart valve, such as mitral valve prolapse
- Abnormal blood level of potassium
- Certain medicines, including those used to treat asthma, high blood pressure, or heart problems
- Overactive thyroid
- Low level of oxygen in your blood
Home Care
Things you can do to limit palpitations include:
- Lower your intake of caffeine and nicotine. This will often reduce heart palpitations.
-
Learn to
reduce stress and anxiety
. This can help prevent palpitations and help you better manage them when they occur.
Reduce stress and anxiety
We all feel stress at one time or another. It's a normal and healthy reaction to change or a challenge. But stress that goes on for more than a few...
- Try deep relaxation or breathing exercises.
- Practice yoga, meditation, or tai chi.
- Get regular exercise.
- Do not smoke.
Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
When to Contact a Medical Professional
If you have never had heart palpitations before, see your health care provider.
Call 911 or your local emergency number if you have:
- Loss of alertness (consciousness)
- Chest pain
-
Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
- Unusual sweating
-
Dizziness
or lightheadedness
Dizziness
Dizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...
Call your doctor right away if:
- You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
- You have risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
- You have new or different heart palpitations.
- Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
What to Expect at Your Office Visit
Your provider will examine you and ask questions about your medical history and symptoms.
You may be asked:
- Do you feel skipped or stopped beats?
- Does your heart rate feel slow or fast when you have the palpitations?
- Do you feel a racing, pounding, or fluttering?
- Is there a regular or irregular pattern to the unusual heartbeat sensations?
- Did the palpitations begin or end suddenly?
- When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
- Do you have any other symptoms?
An electrocardiogram will be done.
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
In the emergency room, you will be connected to a heart monitor.
If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:
-
Holter monitor
for 24 hours, or another heart monitor for two weeks or longer
Holter monitor
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.
-
Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
-
Electrophysiology study
(EPS)
Electrophysiology study
Intracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to check for abnorma...
-
Coronary angiography
Coronary angiography
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
References
Fang JC, O'Gara PT. The history and physical examination. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.
Miller JM, Zipes DP. Diagnosis of cardiac arrhythmias.In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 34.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 62.
-
Cardiac arrhythmia: Heart palpitations and other symptoms
Animation
-
Electrocardiogram (ECG) test overview
Animation
-
Heart chambers - illustration
The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium. From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body.
Heart chambers
illustration
-
Heart beat - illustration
Two distinguishable sounds can be heard during the cycle of the beating heart when listened to with a stethoscope. The heart sounds are usually described as a lup-dup sound. These sounds are due to the closing of the valves of the heart. Unusual heart sounds are called murmurs.
Heart beat
illustration
-
Yoga - illustration
Yoga is a mind-body exercise which combines stretching and controlled breathing to achieve relaxation and a stabilized mood.
Yoga
illustration
-
Cardiac arrhythmia: Heart palpitations and other symptoms
Animation
-
Electrocardiogram (ECG) test overview
Animation
-
Heart chambers - illustration
The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium. From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body.
Heart chambers
illustration
-
Heart beat - illustration
Two distinguishable sounds can be heard during the cycle of the beating heart when listened to with a stethoscope. The heart sounds are usually described as a lup-dup sound. These sounds are due to the closing of the valves of the heart. Unusual heart sounds are called murmurs.
Heart beat
illustration
-
Yoga - illustration
Yoga is a mind-body exercise which combines stretching and controlled breathing to achieve relaxation and a stabilized mood.
Yoga
illustration
Review Date: 5/17/2016
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.