Understanding Heart Palpitations

Heart palpitations are a change in your heart's rhythm. They may feel like an extra-strong heartbeat, skipping, or fluttering. Most often, you feel them in your chest. You may also feel them in your neck, ears, or head.

What causes heart palpitations?

In most cases, heart palpitations are caused by:

• Stress or anxiety.

• Exercise.

• Pregnancy.

• Some medicines.

• Caffeine.

• Nicotine.

• Alcohol.

• Illegal drugs such as cocaine.

• Health problems like anemia or an overactive thyroid.

Many palpitations are harmless. But in some cases, they may be caused by a heart rhythm that's not normal (arrhythmia). You and your doctor may need to manage these long term. Or you may need treatment right away.

How are heart palpitations treated?

Treatments for heart palpitations depend on the cause. They may include:

• Managing the things that trigger your heart palpitations. This could mean:

  • Learning ways to reduce stress and anxiety.

  • Staying away from caffeine, nicotine, alcohol, and illegal drugs.

  • Stopping the use of certain medicines, under your doctor’s care.

• Treating the health problem that is causing your symptoms.

How are heart palpitations diagnosed?

Your doctor will look at your health history, do a physical exam, and order tests. Tests may include:

• Electrocardiogram (ECG) to check your heart's rhythm.

• Blood tests to see if you have any metabolic or hormone problems.

• Ambulatory cardiac monitoring to watch your heart rhythm over time.

• Echocardiogram (ECHO) to check the structure of your heart for problems.

What are possible complications of heart palpitations?

Problems that result from heart palpitations are rare. Sometimes they are caused by a problem like an arrhythmia that keeps going over time. In such cases, they can include:

• Fainting.

• Heart failure. This happens when the heart is so weak it can't pump blood well.

• Blood clots and stroke.

• Sudden cardiac arrest. This happens when the heart suddenly stops beating.

When should I contact my doctor?

Contact your doctor right away if:

• You have palpitations that keep you from sleeping or affect your quality of life in some other way.

• You have symptoms that don’t get better with treatment, or they get worse.

Call 911

Call 911 if:

• You have new symptoms. These may include chest pain or tightness, shortness of breath or trouble breathing, dizziness, confusion, or fainting.

• Sudden numbness or weakness in the face, arms, or legs.