Heart palpitations
Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racingPalpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.
You may:
- Have an unpleasant awareness of your own heartbeat
- Feel like your heart skipped or stopped beats
Your heart's rhythm may be normal or abnormal when you have palpitations.
Considerations
Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise regularly or take medicines that slow the heart.
If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.
Extrasystole
Ectopic heartbeats are changes in a heartbeat that is otherwise normal. These changes lead to extra or skipped heartbeats. There is often not a cle...
Read Article Now Book Mark ArticlePalpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
Read Article Now Book Mark ArticleThe following conditions make you more likely to have an abnormal heart rhythm:
- Known heart disease at the time the palpitations begin
- Significant risk factors for heart disease
Heart disease
Coronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...
Read Article Now Book Mark Article - An abnormal heart valve
- An electrolyte abnormality in your blood -- for example, a low potassium level
Causes
Heart palpitations can be due to:
- Anxiety, stress, panic attack, or fear
- Caffeine intake
- Cocaine, methamphetamine or other stimulant drugs
- Decongestant medications, such as phenylephrine or pseudoephedrine
- Diet pills
- Exercise
- Fever
- Nicotine intake
- Excessive alcohol consumption
However, some palpitations are due to an abnormal heart rhythm, which may be caused by:
- Heart disease
- Abnormal heart valve, such as mitral valve prolapse
Mitral valve prolapse
Mitral valve prolapse is a heart problem involving the mitral valve, which separates the upper and lower chambers of the left side of the heart. In ...
Read Article Now Book Mark Article - Abnormal blood level of potassium
- Certain medicines, including those used to treat asthma, high blood pressure, or heart problems
- Overactive thyroid
- Low level of oxygen in your blood
Home Care
Things you can do to limit palpitations include:
- Lower your intake of caffeine, nicotine, or other stimulants. This will often reduce heart palpitations.
- Learn to reduce stress and anxiety. This can help prevent palpitations and help you better manage them when they occur.
Reduce stress and anxiety
We all feel stress at one time or another. It's a normal and healthy reaction to change or a challenge. But stress that goes on for more than a few...
Read Article Now Book Mark Article - Try deep relaxation or breathing exercises.
- Practice yoga, meditation, or tai chi.
- Get regular exercise.
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Do not smoke.
Do not smoke
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
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Once a serious cause has been ruled out by your health care provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
When to Contact a Medical Professional
If you have never had heart palpitations before, see your provider.
Call 911 or the local emergency number if you have:
- Loss of alertness (consciousness)
- Chest pain
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Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Unusual sweating
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Dizziness or lightheadedness
Dizziness
Dizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...
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Contact your provider right away if:
- You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
- You have heart disease or risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - You have new or different heart palpitations.
- Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
- You have related symptoms, such as chest pain, shortness of breath, feeling faint, or loss of consciousness.
What to Expect at Your Office Visit
Your provider will examine you and ask questions about your medical history and symptoms.
You may be asked:
- Do you feel skipped or stopped beats?
- Does your heart rate feel slow or fast when you have the palpitations?
- Do you feel a racing, pounding, or fluttering?
- Is there a regular or irregular pattern to the unusual heartbeat sensations?
- Did the palpitations begin or end suddenly?
- When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
- Do you have any other symptoms?
- Do you consume stimulant drugs (such as amphetamine or cocaine), caffeine or excessive alcohol?
An electrocardiogram may be done.
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark ArticleIf you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.
If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:
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Holter monitor for 24 hours, or another heart monitor for 2 weeks or longer
Holter monitor
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.
Read Article Now Book Mark Article -
Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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Electrophysiology study (EPS)
Electrophysiology study
Intracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to evaluate abnormal...
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Coronary angiography
Coronary angiography
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
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References
Curtis AB, Tomaselli GF. Approach to the patient with cardiac arrhythmias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 61.
Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 13.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 49.
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Heart chambers - illustration
The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium. From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body.
Heart chambers
illustration
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Heart beat - illustration
Two distinguishable sounds can be heard during the cycle of the beating heart when listened to with a stethoscope. The heart sounds are usually described as a lup-dup sound. These sounds are due to the closing of the valves of the heart. Unusual heart sounds are called murmurs.
Heart beat
illustration
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Yoga - illustration
Yoga is a mind-body exercise which combines stretching and controlled breathing to achieve relaxation and a stabilized mood.
Yoga
illustration
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Heart chambers - illustration
The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium. From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body.
Heart chambers
illustration
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Heart beat - illustration
Two distinguishable sounds can be heard during the cycle of the beating heart when listened to with a stethoscope. The heart sounds are usually described as a lup-dup sound. These sounds are due to the closing of the valves of the heart. Unusual heart sounds are called murmurs.
Heart beat
illustration
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Yoga - illustration
Yoga is a mind-body exercise which combines stretching and controlled breathing to achieve relaxation and a stabilized mood.
Yoga
illustration
Review Date: 4/9/2024
Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.