Maybe you felt your heart skip a beat. Or a flutter in your chest.
Is this cause for concern?
Heart palpitations are fairly common and are usually harmless. But if they are long lasting, frequent or accompanied by dizziness or fainting, they should be checked out by a physician. During this American Heart Month, I encourage people to learn more about heart palpitations, possible causes, treatments and when to seek help.
What are heart palpitations?
Heart palpitations are unusual sensations, such as pounding or racing. The sensations are usually felt in the chest. They can feel like irregular heartbeats, with skipped or extra beats. Some patients describe palpitations as a fluttering feeling. Some describe a pounding or thumping. Others feel as if their heart is racing or beating very fast.
Most palpitations are caused by premature atrial contractions (PACs) or premature ventricular contractions (PVCs). These are early, extra beats that occur just before the main heartbeat.
Heart palpitations can happen at any time. For most people they happen randomly but some find they are more noticeable after eating or when lying down at night, particularly if lying on the left side. Heart palpitations may last seconds, minutes, hours or even days. The longer they last, the more likely they may be caused by an underlying heart condition.
Types of heart rhythms
Heart palpitations may be a symptom of a heart rhythm irregularity, or heart arrythmia. Several heart conditions can cause arrhythmias.
Some fast heart rhythms come from the top chambers of the heart, or the atria. Most arrhythmias stemming from the top chambers are not cause for concern. However, two types of heart rhythm irregularities that may be more serious are atrial fibrillation or atrial flutter because these conditions can predispose patients to strokes. Atrial fibrillation is a problem of the heart's electrical system where the atria quiver, or shake. Blood can pool in the atria, potentially causing harmful blood clots. Heart palpitations can be a symptom of atrial fibrillation.
Atrial flutter causes a fast heart rate and can lead to blood clots and heart failure. Palpitations also are a symptom of this heart condition.
Arrythmias may also stem from the heart's lower chambers, or ventricles. Examples of rare heart irregularities from the lower chambers include ventricular tachycardia and ventricular fibrillation. These conditions, characterized by a very fast heart rhythm, can be extremely serious; they are sometimes associated with passing out or sudden death.
Supraventricular tachycardia is a heart rhythm disorder that causes the heart to beat very quickly. This phenomenon is usually not cause for concern. But some people may feel unwell or feel palpitations, chest discomfort and shortness of breath. Depending on symptoms, supraventricular tachycardia condition can be treated with medications or procedures to control the heart rhythm.
Causes of heart palpitations
Many causes of heart palpitations aren't linked to an underlying heart condition or rhythm irregularity. Some possible causes of occasional heart palpitations include:
- Stress. The heart has receptors for stress hormones. Sometimes patients can get fast heart rhythms that are associated with stress hormones.
- Excess caffeine and alcohol. Consuming caffeine and alcohol is okay in moderation but may trigger heart palpitations in some people.
- Overactive thyroid. Hyperthyroidism can trigger atrial fibrillation and other irregular heart rhythms, particular from the heart's top chambers.
- Dehydration. Severe dehydration means less blood is circulating in the body. As a response, the body will release stress hormones that cause the heart to pump faster and harder, which could lead to a palpitation sensation.
- Medications. Some medications may cause heart palpitations. Be sure to tell your doctor about all of your medications, including all supplements. Pseudoephedrine (Sudafed) and albuterol asthma inhalers have been connected with heart palpitations.
- Hormone changes, particularly related to menstruation and menopause. Some women experience heart palpitations around the time of their period or during the menopause transition.
- Digestive disorders. Indigestion and gastroesophageal reflux disease (GERD) can lead to palpitations.
Patients sometimes ask about the connection between heart palpitations and exercise. If your palpitations are always brought on by exercise, tell your doctor. There might be a higher likelihood that the cause of the palpitations is heart related. However, when we exercise, hormone levels of adrenaline and cortisol are higher in our bodies, and sometimes those hormones can stimulate fast heart rhythms.
When to seek help for heart palpitations
An occasional heart palpitation usually isn't cause for concern. If a heart palpitation lasts a few seconds and happens rarely, you generally don't need to worry but can of course mention it to your physician. Reach out to your doctor if your heart palpitations bother you in any way.
You should certainly reach out to your doctor if your palpitations are frequent and last longer than a few minutes. Also, seek medical attention if you feel faint or light-headed; have chest discomfort or chest pain; are very dizzy; have shortness of breath or trouble breathing; or have pain, pressure or tightness in your chest.
Risks or complications of heart palpitations
Heart palpitations could lead to other complications, such as stroke, heart failure, fainting or cardiac arrest. That is why getting an accurate diagnosis and determining whether there is an underlying cause is so important.
It's helpful to keep a log of when you experience heart palpitations. What were you doing when the palpations began? Were you exercising, eating, sleeping? How long did the palpitations last? How did the palpitations make you feel? Did you faint or pass out?
Diagnosing heart palpitations
To properly diagnose a possible underlying cause of heart palpitations, we will usually have patients to wear a heart monitor to watch their heart activity. A Holter monitor is worn for one to five days and records the heart's rate and rhythm. An event monitor can be used for a longer period of time, usually two to four weeks. Implantable loop recorders are heart-monitoring devices that can be used for a few years. These recorders continuously track heart rhythms. The goal of all of these monitors is to detect the heart palpitations when they happen.
Monitoring heart rhythms helps us determine if the heart palpitations are caused by a heart condition or by something else.
How to lower your risk of heart palpitations
Though heart palpitations can happen to anyone, keeping your heart healthy can lower your risk of developing a serious heart condition. That means eat a healthy, balanced diet, get an adequate amount of sleep and exercise regularly. If you think caffeine or alcohol is causing your heart palpitations, cut back and see if your symptoms improve.
Depending on the underlying cause of the palpitations, medications or surgical procedures may be needed.