A heart palpitation is the sensation that your heart has skipped a beat or
added an extra beat. It may feel like your heart is racing, pounding, or
fluttering. You may become overly aware of your heartbeat. This sensation can
also be felt in the neck, throat, or chest. It’s also possible that your heart
rhythm can change during the palpitations.
Most heart palpitations are harmless and resolve on their own without
treatment. But in rare cases, heart palpitations can indicate a serious
Causes of heart palpitations
Possible causes of heart palpitations include:
- strenuous exercise
- nicotine from tobacco products such as cigarettes and
- hormonal changes, including pregnancy
- electrolyte abnormalities
- low blood sugar
- overactive thyroid, or hyperthyroidism
- low levels of oxygen or carbon dioxide in the blood
- blood loss
- a fever
- over-the-counter (OTC) medications, including cold and
cough medications, herbal supplements, and nutritional supplements
- prescription medications, including beta-blockers,
asthma inhalers, and decongestants
- illegal drugs, such as amphetamines and cocaine
- heart disease
- arrhythmia, or an irregular heart rhythm
- abnormal heart valves
Most heart palpitations are harmless, but they can indicate you have an
illness when you also have:
- an arrhythmia
- a diagnosed heart disease
- heart disease risk factors
- a defective heart valve
When to get
immediate medical attention
Seek medical attention right away if you have heart palpitations and a
diagnosed heart problem. You should also seek medical attention if you have
palpitations that occur with other symptoms such as:
- a loss of consciousness
- difficulty breathing
- excessive sweating
- pain, pressure, or tightening in your chest
- pain in your arms, neck, chest, jaw, or upper back
- a resting pulse rate of more than 100 beats per minute
These could be symptoms of a more serious condition.
Diagnosing the cause of heart palpitations
The cause of heart palpitations can be very difficult to diagnose,
especially if the palpitations don’t occur while you’re in the doctor’s office.
Your doctor will conduct a thorough physical exam to identify a cause. Be
prepared to answer questions about your
- physical activities
- stress levels
- prescription medication use
- OTC medication and supplement use
- health conditions
If necessary, your doctor may refer you to a heart specialist called a
cardiologist. Tests to help rule out certain diseases or heart problems
- blood tests
- urine tests
- a stress test
- a recording of the heart’s rhythm for 24 hours using a
machine called a Holter monitor
- an ultrasound of the heart, or an echocardiogram
- an electrocardiogram
- a chest X-ray
- an electrophysiology study to check your heart’s
- a coronary angiography to check how blood flows through
Treatment for heart palpitations
Treatment depends on the cause of your palpitations. Your doctor will need
to address any underlying medical conditions.
Most of the time, the doctor isn’t able to find the cause and they aren’t
able to provide treatment.
If your palpitations are due to lifestyle choices such as smoking or
consuming too much caffeine, cutting down or eliminating those substances may
be all that you need to do. Ask your doctor about alternative medications or
treatments if you think medication may be the cause.
If your doctor tells you that treatment isn’t necessary, you can take these
steps to decrease your chance of getting palpitations:
- Try to identify your triggers so that you can avoid
them. You can do this by keeping a log of your activities, as well as the
foods and beverages you eat and noting when you get palpitations.
- If you’re anxious or stressed, try relaxation
exercises, deep breathing, yoga, or tai chi.
- Limit or stop your intake of caffeine.
- Don’t smoke or use tobacco
- If medication is causing palpitations, ask your doctor
if there are any alternatives.
- Exercise regularly.
- Stick to a healthy diet.
- Try to keep your blood pressure and cholesterol levels under control.