Have you ever felt like your heart was racing? Or has your heart ever beat so hard that you felt it not only in your chest, but even in your throat and neck? Maybe you have even noticed a change in your heart’s rhythm or felt extra beats. We are generally not aware of our heartbeat. However, there are times when our heart makes its presence known by beating faster and harder. We call these noticeable changes in heartbeat palpitations—abnormal beatings of the heart.

Symptoms of Heart Palpitations

Heart palpitations may cause you to feel like your heart is beating too fast, like there is a fluttering in your chest, like your heart is skipping a beat, or even stopping for a moment. Depending on the cause of the palpitation, you may feel these sensations during activity, or even when you are at rest.

Most often, palpitations are harmless and require no treatment. But if you notice any of the following symptoms along with an abnormal heartbeat, you should consult your doctor since it could be a sign of a serious condition.

• Dizziness

 

• Confusion

 

• Feeling faint, or fainting

 

• Tightness or pain in the chest, jaw or arm

 

• Shortness of breath

 

• Sweating

To help your doctor determine the cause and severity of your palpitations, keep track of your palpitations by recording the symptoms, date, time, and duration of the episode.  Also note any activity and information about the food and medications you consumed prior to feeling palpitations. 

At a doctor visit, you will likely be asked about other symptoms, use of medication, medical history, activities, and your diet. The first test a doctor will generally run is called an electrocardiogram (EKG) to rule out more serious causes of abnormal heartbeats. This test records your heart’s electrical activity and can detect and locate the source of any heart problems. If your doctor still has concerns after an EKG, he or she may ask you to undergo a blood test, a urine test, a stress test, a chest X-ray, or an echocardiogram (heart ultrasound). Your doctor may also refer you to a heart specialist, a cardiologist, for further testing and analysis before deciding on a treatment.

Causes of Heart Palpitations

You may feel your heart race when under emotional or physical stress, like when you are trying to meet a deadline, about to give a speech, or when you exercise. You may also feel these abnormal heartbeats when you are at rest and not moving at all. Heart palpitations can have many different internal and external causes. It is important to recognize the causes of heart palpitations so you can control them, or better yet, can prevent them from happening.

Sometimes palpitations could be caused by a serious, underlying disease or condition. Existing heart conditions can even lead to other complications such as fainting, cardiac arrest, stroke, or heart failure. Some of the more serious causes of heart palpitations are listed below.

• Arrhythmia, a problem with the rate or rhythm of the heartbeat, can cause palpitations. A normal heart beats between 60 and 100 times a minute, but that rate will be higher or lower in someone with a form of arrhythmia. If your heart beats more than 100 times a minute, the form is called tachycardia. If your heart beats less than 60 times per minute, the form is called bradycardia. Prior heart attacks or heart valve and muscle conditions can also increase the risk of heart palpitations.

• Hyperthyroidism (overactive thyroid gland)

• Anemia, especially in pregnant women

• Anxiety disorder or panic attacks that occur regularly

Other causes of palpitations are not related to a prior illness or disease. Palpitations that stem from causes, like the ones listed below, generally pose little risk of complications. Palpitations will likely stop if these conditions go away or change.

• Strong emotions stemming from temporary fear, nervousness, or stress may leave your heart pounding. These emotions can cause adrenaline to rise, but normally leave no lasting effect on the heart and generally require no treatment.

• Menstruation, pregnancy, and menopause can result in hormone changes, which can lead to bouts of palpitations. Often, these palpitations only occur during these phases when hormones fluctuate and are not thought to have long-term effects on the heart.

• Alcohol as well as caffeine from products like coffee, soda, or energy drinks; nicotine, from products such as cigarettes and chewing tobacco; and other stimulants may cause sudden changes in heart rate. Some over-the-counter medicines also act as stimulants, such as some cough or cold formulas.

• Some prescription drugs that treat the thyroid gland, asthma, or even arrhythmia (irregular heart rhythm) can cause extra heartbeats or an increase in heart rate. Even if you already have arrhythmia, the medication for that condition can cause additional changes in heart rhythm.

• Illegal drugs, such as amphetamines or cocaine can cause the heart to temporarily beat faster, often at a dangerous rate.

• Dehydration

• Fever

• Exercise

Generally, heart palpitations do not require any treatment and will go away on their own, especially if they are caused by temporary stress, emotion, or activity. But treatments are available for palpitations caused by an underlying heart condition or illness.

If your palpitations stem from hyperthyroidism, it is best to visit an endocrinologist. Drug therapy is the most common form of treatment. In some cases, he or she will recommend an “anti-thyroid” drug, possibly taken with hormone supplements. This will bring thyroid hormone levels back into balance.

In other cases, he or she may recommend a beta-blocker—a drug that counteracts the effect of thyroid hormone and slows down metabolism. In both cases, palpitations should cease once metabolism and hormone production are in normal range.

If anemia is causing your palpitations, the doctor may treat you by prescribing iron, vitamin B12, vitamin C, or folic acid supplements, or he may simply recommend changing your diet to include more of these vitamins and minerals. In some specific cases, there may be a need to prescribe medicines that increase red blood cell production, fight infections, decrease menstrual flow, or treat other underlying causes of anemia. In more severe cases, blood transfusions or even surgery may be necessary. In any case, once the anemia is resolved, palpitations should subside.

Arrhythmia may be treated in a number of ways, depending on the severity and cause of the arrhythmia. In some cases, medication that simply slows the heart rate or prevents arrhythmias may be used. In other cases, an external electrical device may be used to restore a normal rhythm. Medications may be prescribed along with these procedures.

If these treatments are not effective, an open-heart surgery may be required, or a pacemaker or defibrillator may be implanted.

In all cases, once the underlying condition is resolved, you will likely be free of palpitations.

Preventing Palpitations

It is important to know the symptoms of palpitations and possible causes of palpitations. But it is equally important to know how to prevent palpitations from happening. Keeping your heart, body, and mind healthy can prevent most palpitations. Here are some tips to keep palpitations and their complications at bay.

• Monitor your blood pressure and cholesterol to keep them within healthy limits.

• Try to reduce your exposure to stress by keeping a manageable schedule, avoiding stressful situations when possible, and by managing stress through relaxation techniques such as yoga, tai chi, or massages.

• Follow a regular exercise program. Work with your doctor to create a manageable plan if you are just getting started. This will help keep your heart strong and healthy and can help in reducing stress.

• Limit consumption of alcohol, coffee, and other products that contain caffeine or stimulants. Remember to check with your doctor to see if over-the-counter medications or herbal supplements taken by you fall into these categories.

• Avoid any form of nicotine; if smoking is already a habit, try to quit.

• Drink plenty of water to stay hydrated.

• Report any side effects of prescription medications to your doctor.

Keep a Steady Beat

If you have experienced episodes of palpitations, it is important to work with your physician to identify the cause of your palpitations and to know what triggers an episode. Most palpitations are not a cause for worry and do not require treatment; however some palpitations are indicative of an underlying heart condition and can be treated based on the underlying cause by using medications or using electrical devices to bring the heartbeat to normal rhythm.

Most importantly, try to prevent palpitations from happening by managing stress, eating well, and incorporating regular exercise into your schedule. A healthy lifestyle is the key to a palpitation-free life.