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 chest or the
feeling of a "skipped beat," while others note a "pounding sensation" or feel
that their hearts are "jumping out of their chest." Palpitations are rarely
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 determine 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.
While your doctor will likely not diagnose an arrhythmia based on
your demonstration, 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 with 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 with coronary artery disease, a rapid
heart rate can cause angina. How you describe your pain may help your doctor
determine 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,
and will probably order an electrocardiogram (EKG, ECG) or further stress
testing to evaluate the rhythm or rule out angina.
If you have an arrhythmia that causes your heart to beat too fast or
too slow, you may feel lightheaded or dizzy. This happens because your heart
cannot pump blood effectively during excessively fast or slow heart rates. The
ineffective pumping action decreases your blood pressure, reducing the amount
of blood that reaches your brain.
The sensation of lightheadedness is a result of this lack of blood
flow to the brain. If your blood pressure drops too low, you may feel that you
are about to pass out. This sensation is called presyncope. Syncope is the
medical term for a temporary loss of consciousness (passing out).