Understanding Heart Palpitations

Heart palpitations are the feeling you have when your heartbeat seems to be racing, pounding, skipping, or fluttering. Heart palpitations are most often felt in the chest. They may also sometimes be felt in the neck, ears, or head.

What causes heart palpitations?

In most cases, heart palpitations are caused by:

• Stress or anxiety

• Exercise

• Pregnancy

• Some medicines

• Caffeine

• Nicotine

• Alcohol

• Illegal drugs such as cocaine

• Health problems such as anemia or overactive thyroid

Many heart palpitations are harmless. But in some cases, palpitations may be caused by a problem. This might be an abnormal heart rhythm (arrhythmia). You and your healthcare provider may need to manage these long term. Or you may need treatment right away.

How are heart palpitations treated?

Treatments for heart palpitations depend on the cause. Choices may include:

• Managing the things that trigger your heart palpitations. This could mean:

  • Learning ways to reduce stress and anxiety

  • Staying away from caffeine, nicotine, alcohol, and illegal drugs

  • Stopping the use of certain medicines, under your doctor’s guidance

• Taking medicines or having procedures or surgery to treat an arrhythmia or other health problem that is causing your symptoms

How are heart palpitations diagnosed?

Your provider will diagnose the cause of your heart palpitations by looking at your health history, doing a physical exam, and ordering tests. Tests may include:

• Electrocardiogram (ECG) to assess your heart's rhythm

• Blood work to see if you have any metabolic or endocrine problems

• Ambulatory cardiac monitoring to monitor your heart rhythm over time

• Echocardiogram (ECHO) to assess your heart for structural problems

What are possible complications of heart palpitations?

Complications of heart palpitations are rare unless they are caused by a problem such as an arrhythmia. In such cases, complications can include:

• Fainting

• Heart failure. This problem occurs when the heart is so weak it no longer pumps blood well.

• Blood clots and stroke

• Sudden cardiac arrest. This problem occurs when the heart suddenly stops beating.

When should I call my healthcare provider?

Call your healthcare provider right away if you have any of these:

• Palpitations that prevent you from sleeping or otherwise affect your quality of life.

• Symptoms that don’t get better with treatment, or symptoms that get worse

Call 911

Call 911 if any of the following occur:

• New symptoms, such as chest pain or tightness, shortness of breath or trouble breathing, dizziness, confusion, or fainting

• Sudden numbness or weakness in the face, arms, or legs