People are not usually aware of their heartbeat, but sometimes, it comes to their notice. This may be because their heart is pounding too hard, too fast, too slow, or irregularly.
This article explores the causes of heart palpitations, how to test for them, and some treatment options.
Common causes
Many factors can trigger heart palpitations. Some causes include physical or mental stress, anxiety, dehydration, and lack of sleep.
However, they can also indicate an underlying heart problem.
Heart conditions
The British Heart Foundation notes that palpitations can stem from a wide range of underlying heart conditions, such as:
cardiomyopathy, wherein the heart becomes enlarged
heart valve problems
congenital heart disease
Palpitations can also result from arrhythmia, which refers to any changeTrusted Source to a person’s regular heartbeat.
Causes of arrhythmia include:
atrial flutter, which is a fast and irregular heartbeat
ventricular tachycardia, which occurs when the lower chambers of the heart pump too fast, reducing the amount of oxygen in the blood
atrial fibrillation, which is when there is a short circuit in the heart that causes the atria, or upper chambers in the heart, to pump rapidly
supraventricular tachycardia, which is when the heart suddenly beats a lot faster than normal
It may also be a warning sign of heart failure or a heart attack, both of which can result from a range of structural and other issues.
Emotional factors
Strong emotions can cause heart palpitations.
Emotional factors that can trigger heart palpitations include:
anxiety
stress
panic
depression
insomnia or lack of sleep
What is the link between anxiety and heart palpitations?
Medication
Certain medications can also trigger heart palpitations.
According to the United Kingdom’s National Health Service (NHS), the following medicines may trigger palpitations:
asthma inhalers
antihistamines
high blood pressure medications
antibiotics
antidepressants
antifungal medications
Medication for attention deficit hyperactivity disorder, such as Adderall, may also cause heart palpitations.
Medical conditions
Certain underlying medical conditions may be the cause of heart palpitations. These includeTrusted Source:
an overactive or underactive thyroid
low blood sugar levels
high or low potassium levels
levels of magnesium that are too low or high
pheochromocytenia, which is a type of neuroendocrine tumor
Other medical conditions include:
dehydration
diabetes
anemia
postural hypotension, which is when a person experiences dizziness and low blood pressure when standing up
a high fever
sleep apnea
Lifestyle
Lifestyle factors that may cause heart palpitations include:
caffeine consumption, including tea, coffee, or energy drinks
alcohol consumption
tobacco smoking
strenuous exercise
using recreational drugs, such as cannabis, cocaine, heroin, ecstasy, or amphetamines
rich or spicy food consumption
Why do heart palpitations happen after eating?
Hormonal changes
Hormonal changes are another possible cause. Changes in hormone levels may result from:
menstrual periods
pregnancy
menopause
thyroid problems
Learn more about why heart palpitations happen here.
Are they normal?
In many cases, palpitations can be scary but not serious. However, they can be a symptom of arrhythmia and may also be a warning sign of cardiac arrest.
For this reason, it is a good idea for people who experience heart palpitations to seek medical advice.
Symptoms
People experience heart palpitations in different ways.
The NHS notes that some common descriptions include the heart:
pounding
fluttering
beating harder, faster, or irregularly
A person may feel a heart palpitation in the neck, throat, or chest. They may also feel them in their ear if they are lying down.
For some people, palpitations last for only a few seconds, while others may experience them for minutes or hours at a time.
How do doctors diagnose the cause?
A doctor will likely:
ask about symptoms
carry out a physical exam
look at the individual’s medical history
do a test using a 12-lead electrocardiogram (ECG)
An ECG measures heart rate and rhythm parameters through electrical tracing.
Depending on the symptoms, the doctor may also do blood tests, an exercise stress test, and other investigations, such as asking the person to wear an arrhythmia monitor at home.
They may also refer the person to a cardiologist.
People may find it useful to keep a diary noting the following information:
what their palpitations feel like
how often they happen
when they happen
what the triggers are
whether they last for seconds, minutes, or hours
Being able to answer some of the following questions may also help with diagnosis:
Is the heart rate too fast or slow during a palpitation episode, and is the rhythm regular or irregular?
Is there lightheadedness, dizziness, shortness of breath, or chest pain?
Do the palpitations tend to occur during a particular activity? Is there a pattern?
Do the palpitations start and stop suddenly or fade in and out?
Treatment options
Not everyone with heart palpitations will need treatment. If they do, it will depend on the type of palpitations, the person’s symptoms, and the cause and amount of palpitations they are experiencing. Options include:
Emotional causes: A person may find it beneficial to learn how to deal with a panic attack and use breathing techniques to help remain calm.
Medication: If a person starts to have palpitations while taking certain medications, a doctor may recommend an alternative.
Lifestyle: The heart palpitations should resolve without treatment, and people may find it beneficial to avoid the triggers.
Hormonal: Heart palpitations that occur due to hormonal changes are usually temporary.
The doctor may prescribe antiarrhythmic drugs, such as beta-blockers or non-dihydropyridine calcium channel blocker therapy. Beta-blockers slow the heart rate and reduce blood pressure.
If a person has arrhythmia, a healthcare professional may recommend the following medical procedures:
Catheter ablation surgery: During catheter ablation surgery, a cardiologist will thread an ablation device into the heart through a catheter that passes through a deep vein in the groin, neck, or chest. The device causes scars to form over faulty electrical tracts in the heart. This can help correct the way electrical impulses travel through the heart.
Electrical cardioversion: This procedure involvesTrusted Source sending an electrical shock into the chest wall to try to stabilize a person’s heart rhythm and rate. A doctor may choose this therapy to “reset” the electrical rhythm of the heart.
Implantable pacemaker or defibrillator placement: A pacemaker is a permanent cardiac device that monitors and treats electrical conditions of the heart.
Home remedies
Some people experience regular palpitations, which may be bothersome. To reduce these, a person can try the following:
Find a comfortable position and relax.
Perform deep breathing techniques.
Try to avoid panic, as this can worsen symptoms.
Take magnesium supplementation, although a person should discuss this with a doctor first.
Stay hydrated.
People may also try the Valsalva maneuver breathing method. A 2015 study found that the Valsalva maneuver is a simple and noninvasive method for stopping an abnormal heart rhythm. However, the researchers also noted that more research is necessary.
Complications
Many cases of heart palpitations are harmless. However, if they are a sign of an underlying heart condition, there can be serious complications.
Some heart conditions, such as atrial flutter, can lead to stroke.
Heart palpitations can also be a symptom of heart failure and may precede cardiac arrest.
Some people may faint due to a sudden drop in blood pressure. Always get palpitations checked out and discuss management with a healthcare professional.
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Prevention
Often, lifestyle strategies can help reduce or stop nonserious palpitations. For example, people should try to reduce or avoid the following:
caffeine
alcohol
tobacco
any medications that may trigger palpitations
Other tips include:
following a healthy diet
getting enough sleep
getting regular exercise
doing yoga, meditation, breathing exercises, or tai chi to help manage stress
avoiding known triggers or learning new ways to approach them
These measures may also help reduce the risk of heart disease.
Visit our cardiovascular health hub to learn more about the functioning of the heart.
When to contact a doctor
Heart palpitations usually pass quickly and are not serious, but it is a good idea to speak with a doctor if they occur.
If a person of any age experiences heart palpitations, they should contact a doctor. In addition, anyone with the following should contact a doctor if palpitations occur:
a history of heart problems
palpitations that worsen or do not improve
other symptoms, such as chest pain
other health concerns
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