Heart Disease Health Center

Heart Palpitations

Heart palpitations are a feeling that your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

Heart palpitations can be bothersome or frightening. They usually aren't serious or harmful, though, and often go away on their own. Most of the time, they're related to stress and anxiety or to consumption of stimulants such as caffeine, nicotine, or alcohol. Palpitations also often occur during pregnancy.

In about one out of seven cases, the cause can't be identified.

In rare cases, palpitations can be a sign of a more serious heart condition. Therefore, if you have heart palpitations, make arrangements to see your doctor. And seek immediate medical attention if along with palpitations you experience shortness of breath, dizziness, chest pain, or fainting.

After taking your medical history and conducting a physical exam, your doctor may order tests that can either confirm or rule out an underlying cause. If an underlying cause is found, the right treatment can reduce or eliminate palpitations. If your palpitations are not related to an underlying cause, lifestyle changes, including stress management and the avoidance of common triggers, can help prevent them.

Causes of Heart Palpitations

Many things can cause heart palpitations. In the vast majority of cases, the cause is either related to your heart or is unknown. Non-heart-related causes of palpitations include:

• Strong emotions such as anxiety, fear, or stress. Palpitations often occur during panic attacks.
• Vigorous physical activity.
• Caffeine, nicotine, alcohol, or illegal street drugs such as cocaine and amphetamines.
• Certain medical conditions. These include thyroid disease, a low blood sugar level, anemia, some types of low blood pressure, fever, and dehydration.
• Hormonal changes during menstruation, pregnancy, or the perimenopausal period. Sometimes, palpitations during pregnancy are signs of anemia.
• Certain medications. These include diet pills, decongestants, asthma inhalers, and some medications used to prevent arrhythmias (a serious heart rhythm problem) or treat an underactive thyroid.
• Certain herbal and nutritional supplements.
• Abnormal electrolyte levels.

Some people experience palpitations after eating heavy meals that are rich in carbohydrates, sugar, or fat. Sometimes eating foods with high levels of monosodium glutamate (MSG), nitrates, or sodium can bring them on.

If you have heart palpitations after eating certain foods, the problem could be food sensitivity. Keeping a food diary can help you identify which foods to avoid.

Palpitations can also be related to underlying heart disease. When they are, palpitations are more likely to represent arrhythmia. Heart conditions associated with palpitations include:

• Prior heart attack.
• Coronary artery disease.
• Other heart problems such as congestive heart failure, heart valve problems, or heart muscle problems.

Assessment of Heart Palpitations

Your doctor will conduct a physical examination, take your medical history, and ask about your current medications, diet,and lifestyle. The doctor also will ask when, how often, and under what circumstances palpitations occur.