You can feel your heart thudding away every time you put your hand to your chest, but do you have any idea what’s really going on in there or what keeps your heart ticking as it should? WebMD the Magazine asked Richard Krasuski, MD, director of Adult Congenital Heart Disease Services and a staff cardiologist at the Cleveland Clinic, to help explain some amazing and little-known facts about the human heart.
Having palpitations means that you are unusually aware of your heartbeat. The experience of palpitations is often described differently by different people. Some people report a vague "fluttering" in their chests or the feeling of a "skipped beat." Others note a "pounding sensation" or feel that the heart is "jumping out of my chest." Palpitations are rarely painful.
What are the different types of palpitations?
The pattern of the palpitations can be very helpful in determining the type of arrhythmia that caused them. If you see a doctor about your palpitations, it is very helpful if you can demonstrate the rhythm and speed of the palpitations by tapping your fingers on a desk or table. This can help your doctor figure out whether the palpitations were the result of an arrhythmia and in some cases may allow a relatively accurate diagnosis as to the specific arrhythmia that caused the palpitations.
Your doctor will likely not diagnose an arrhythmia based on your demonstration. But it can be a very helpful start if you are not experiencing arrhythmia while you are in your doctor's office (which means your doctor will be unable to record the arrhythmia on an EKG during the visit).
How do palpitations cause chest discomfort?
Some people experience rapid heart rates not as palpitations but rather as chest pain. In people who have healthy hearts, palpitations may cause a pounding or thumping sensation that can be painful or uncomfortable, rather than the heavy, tight, or squeezing sensation, called angina, usually associated with heart attacks. In people who have coronary artery disease, a rapid heart rate can cause angina. How you describe your pain may help your doctor figure out whether the chest pain is the result of an abnormal rhythm or angina. In many cases, your doctor may not be sure based strictly on your description. So he or she will probably order an electrocardiogram (EKG, ECG) or further stress testing to evaluate the rhythm or rule out angina.