Heart palpitations

Overview

Heart palpitations (pal-pih-TAY-shuns) are the 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. In rare cases, they can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

Symptoms

Heart palpitations can feel like your heart is:

• Skipping beats
• Fluttering rapidly
• Beating too fast
• Pounding
• Flip-flopping

You might feel heart palpitations in your throat or neck, as well as your chest. They can occur when you're active 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 doctor. He or she might suggest heart-monitoring tests to see if your palpitations are caused by a more serious heart problem.

Seek emergency medical attention if heart palpitations are accompanied by:

• Chest discomfort or pain
• Fainting
• Severe shortness of breath
• Severe dizziness

Causes

Often the cause of your heart palpitations can't be found. Common causes include:

• Strong emotional responses, such as stress, anxiety or panic attacks
• Depression
• Strenuous exercise
• Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
• Fever
• Hormone changes associated with menstruation, pregnancy or menopause
• Too much or to little thyroid hormone

Occasionally heart palpitations can be a sign of a serious problem, such as an overactive thyroid gland (hyperthyroidism) or an abnormal heart rhythm (arrhythmia). Arrhythmias might cause a very fast heart rate (tachycardia), an unusually slow heart rate (bradycardia) or an irregular heart rhythm.

Risk factors

You might be at risk of developing palpitations if you:

• Are highly stressed
• Have an anxiety disorder or have regular panic attacks
• Are pregnant
• Take medicines that contain stimulants, such as some cold or asthma medications
• Have an overactive thyroid gland (hyperthyroidism)
• Have other heart problems, such as an arrhythmia, heart defect, previous heart attack or previous heart surgery

Complications

Unless a heart condition is causing your heart palpitations, there's little risk of complications. For palpitations caused by a heart condition, possible complications include:

• Fainting. If your heart beats rapidly, your blood pressure can drop, causing you to faint. This might be more likely if you have a heart problem, such as congenital heart disease or certain valve problems.
• Cardiac arrest. Rarely, palpitations can be caused by life-threatening arrhythmias and can cause your 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. This can result if your heart is pumping ineffectively for a prolonged period due to an arrhythmia, such as atrial fibrillation. Sometimes, controlling the rate of an arrhythmia that's causing heart failure can improve your heart's function.