Heart palpitations are sensations where you feel like your heart is pounding, fluttering, skipping beats, or beating too fast. They may occur in your chest, throat, or neck and can last for a few seconds to several minutes. While they are often harmless and related to stress, caffeine, or exercise, palpitations can sometimes indicate an underlying medical condition, such as an arrhythmia or heart disease. It is important to understand when these sensations are benign and when they may require medical attention.
Symptoms and Causes
Symptoms: Heart palpitations can feel like:
- A fluttering sensation in the chest
- The heart “skipping” beats
- A pounding or racing heart (tachycardia)
- The heart beating too hard
- A feeling of flip-flopping in the chest
These sensations may occur when you are at rest, during exercise, or when you change positions. Other associated symptoms that may occur alongside palpitations include:
- Dizziness or lightheadedness
- Shortness of breath
- Chest discomfort or pain
- Fatigue or weakness
- Sweating or feeling faint
Causes: While heart palpitations can be caused by harmless factors, they may also indicate an underlying issue. Common causes include:
Non-Cardiac Causes:
- Stress, Anxiety, or Panic Attacks: Emotional stress or anxiety can trigger the release of adrenaline, which can cause palpitations.
- Caffeine or Nicotine: Stimulants like caffeine, nicotine, or other recreational drugs can increase heart rate and lead to palpitations.
- Physical Activity: Exercise or physical exertion can cause temporary palpitations.
- Hormonal Changes: Hormonal fluctuations, such as those during pregnancy, menstruation, or menopause, can lead to palpitations.
- Medications: Some medications, including those for asthma, decongestants, or weight loss, can stimulate the heart and cause palpitations.
- Fever, Dehydration, or Low Blood Sugar: These conditions can affect heart rate and cause palpitations.
Cardiac Causes:
- Arrhythmias: Abnormal heart rhythms, such as atrial fibrillation, tachycardia, or premature ventricular contractions (PVCs), can cause palpitations.
- Heart Disease: Coronary artery disease, heart failure, or structural issues like heart valve problems may lead to palpitations.
- Electrolyte Imbalances: Low levels of potassium, calcium, or magnesium can disrupt the heart’s electrical activity, leading to palpitations.
- Thyroid Disorders: An overactive thyroid (hyperthyroidism) can increase heart rate and cause palpitations.
Diagnosis and Treatment
Diagnosis: To determine the cause of heart palpitations, a physician will review your medical history, perform a physical exam, and may order specific tests. Diagnostic tests include:
- Electrocardiogram (ECG/EKG): Records the heart’s electrical activity to detect arrhythmias or other abnormalities that may cause palpitations.
- Holter Monitor: A portable ECG device worn for 24-48 hours to monitor heart activity over a longer period and capture palpitations that occur sporadically.
- Event Monitor: Similar to a Holter monitor but used for longer periods (weeks or months) to record irregular heart rhythms when they happen.
- Echocardiogram: An ultrasound of the heart that assesses its structure and function, helping detect underlying heart conditions like valve problems or cardiomyopathy.
- Stress Test: Evaluates the heart’s activity during exercise to determine if physical exertion triggers palpitations or arrhythmias.
- Blood Tests: Used to check for electrolyte imbalances, thyroid function, or other factors that may cause palpitations.
Treatment: The treatment for heart palpitations depends on the underlying cause and the severity of symptoms. If no serious cause is found, treatment may involve lifestyle changes. For other cases, medical intervention may be necessary:
Lifestyle Changes:
- Stress Management: Techniques such as meditation, deep breathing exercises, or yoga can help manage stress and reduce palpitations.
- Limit Stimulants: Reducing or avoiding caffeine, nicotine, or other stimulants that can increase heart rate.
- Hydration: Staying well-hydrated can help maintain electrolyte balance and prevent palpitations.
- Dietary Adjustments: Eating small, frequent meals to maintain blood sugar levels and including electrolyte-rich foods to prevent imbalances.
Medications:
- Beta-Blockers: Used to slow down the heart rate in cases where palpitations are frequent and bothersome.
- Antiarrhythmic Medications: Prescribed for individuals with arrhythmias causing palpitations.
- Electrolyte Supplements: May be recommended if blood tests reveal deficiencies in potassium, calcium, or magnesium.
Medical Procedures:
- Catheter Ablation: A minimally invasive procedure that targets and destroys small areas of heart tissue responsible for abnormal electrical signals causing arrhythmias.
- Pacemaker or Implantable Cardioverter-Defibrillator (ICD): In severe cases where arrhythmias are life-threatening, a pacemaker or ICD may be implanted to regulate heart rhythms.
When to See a Physician
You should seek medical attention if you experience any of the following symptoms:
- Palpitations that last longer than a few minutes or occur frequently
- Dizziness, lightheadedness, or fainting spells
- Chest pain, discomfort, or pressure
- Shortness of breath or difficulty breathing
- A history of heart disease or other cardiovascular risk factors (such as high blood pressure, high cholesterol, or diabetes)
If you are concerned about your heart palpitations or if they are accompanied by any of the above symptoms, it’s important to see a physician for evaluation and to rule out any serious underlying conditions.
Benefits of Early Diagnosis and Treatment
- Peace of Mind: Understanding the cause of palpitations and ruling out serious conditions can alleviate anxiety and provide reassurance.
- Improved Quality of Life: Addressing triggers or underlying conditions can help reduce or eliminate palpitations, allowing for a more active and comfortable lifestyle.
- Prevention of Complications: Early diagnosis and treatment of heart-related causes, such as arrhythmias or thyroid issues, can prevent complications like heart failure or stroke.
- Personalized Care: Tailored treatment plans based on the specific cause of palpitations ensure that the most effective measures are taken, whether through lifestyle changes, medication, or procedures.
