Heart palpitations (pal-pih-TAY-shuns) are feelings of having a fast-beating, fluttering or pounding heart. Stress, exercise, medication or, rarely, a medical condition can trigger them.
Although heart palpitations can be worrisome, they're usually harmless. Rarely, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.
Heart palpitations can feel like the heart is:
- Beating too fast
- Fluttering rapidly
- Skipping beats
Heart palpitations may be felt in the throat or neck as well as the chest. They can occur during activity or at rest.
When to see a doctor
Palpitations that are infrequent and last only a few seconds usually don't need to be evaluated. If you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your health care provider. You may need heart-monitoring tests to see if the palpitations are caused by a more serious heart problem.
Seek emergency medical attention if heart palpitations occur with:
- Chest discomfort or pain
- Severe shortness of breath
- Severe dizziness
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Often the cause of heart palpitations can't be found. Common causes include:
- Strong emotional responses, such as stress, anxiety or panic attacks
- Strenuous exercise
- Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
- Hormone changes associated with menstruation, pregnancy or menopause
- Too much or too little thyroid hormone
Occasionally heart palpitations can be a sign of a serious problem, such as an irregular heart rhythm (arrhythmia).
Arrhythmias might cause a very fast heartbeat (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rhythm or a combination of the three.
Risk factors for heart palpitations include:
- Anxiety disorder or panic attack
- Certain medicines that contain stimulants, such as some cold or asthma medications
- An overactive thyroid gland (hyperthyroidism)
- Other heart problems, such as irregular heartbeats, structural heart changes, previous heart attack or previous heart surgery
For palpitations caused by a heart condition, possible complications may include:
- Fainting. If the heart beats rapidly, blood pressure can drop, causing the person to faint. This is more likely in those with a heart problem, such as congenital heart disease or certain valve problems.
- Cardiac arrest. Rarely, palpitations can be caused by life-threatening heartbeat problems and can cause the heart to stop beating effectively.
- Stroke. If palpitations are due to a condition in which the upper chambers of the heart quiver instead of beating properly (atrial fibrillation), blood can pool and cause clots to form. If a clot breaks loose, it can block a brain artery, causing a stroke.
- Heart failure. Certain arrhythmias can reduce the heart's pumping ability. Sometimes, controlling the rate of an arrhythmia that's causing heart failure can improve the heart's function.