Heart Palpitations

What are palpitations?

Palpitations are an uncomfortable awareness of your heartbeat. You may feel that your heart is beating harder or faster than usual or that it is skipping a beat or two.

Palpitations are common and often normal. They are a symptom, not a disease. However, it is important to determine their cause.

How do they occur?

Palpitations may be brought on by:

• exercise
• stress, anxiety, or fear
• smoking
• alcohol
• too much caffeine from coffee, colas, or tea
• anemia
• heart problems, such as mitral valve prolapse
• a thyroid problem
• medicines, such as diet pills and decongestants, or overdoses of such medicines as theophylline and antidepressants
• premenstrual syndrome (PMS)
• a lack of certain vitamins or minerals
• low blood sugar, or an insulin reaction in diabetics.

What are the symptoms?

Symptoms may include:

• thumping, pounding, or racing sensation in your chest
• fluttering sensation in your chest
• feeling of irregular beating or skipped beats.

How are they diagnosed?

Your health care provider will review your symptoms and examine you. You may have an electrocardiogram (ECG) or other tests to help find the cause. You may be given a heart monitor to wear at home. You may have an ultrasound test of the heart called an echocardiogram or an exercise stress test to see if heart problems are causing the palpitations.

How are they treated?

Treatment of palpitations depends on the cause. Most often, no treatment is needed because the heart is otherwise normal. Drinking less coffee or alcohol, or none at all, may be all you need to do. Trying to reduce the stress in your life may help. Some medicines can decrease or eliminate the palpitations. Talk with your health care provider about this.

How can I take care of myself?

• Take the medicine prescribed and follow your health care provider's advice for lifestyle changes.
• Keep a record of when, how often, and for how long you have each episode of palpitations. It is helpful for your provider to know if the palpitations came on suddenly or gradually and whether they stopped suddenly or gradually. Note what you were doing and whether you noticed any other symptoms during the episode.
• Don't smoke. Tell your health care provider if you need help quitting.
• Avoid alcohol. Ask your provider if you need help.
• If you are overweight, talk to your provider about losing weight.
• Exercise regularly, according to your provider's advice.
• Learn to relax. Reduce stress and anxiety in your life.

Call your health care provider right away if:

• You have palpitations that last a few hours.
• They occur often.
• You also have sweating, shortness of breath, lightheadedness, nausea, vomiting, or pain in the chest, arm, back, or jaw.

If the palpitations happen often, particularly if you also have chest pain, breathlessness, or dizziness, you may have another medical problem that your health care provider can identify and treat.