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Heart Palpitations
Overview
You may have a condition called heart palpitations if you sometimes feel like your heart is:
- Pounding (beating very hard)
- Racing (beating too fast)
- Skipping beats
- Flip-flopping
- Fluttering
Many people have heart palpitations at times. Usually this isn’t related to a serious heart problem. 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.
To find out whether your palpitations are harmless or signal a heart problem, make an appointment with your doctor.
Symptoms
Heart palpitations are unusual sensations, such as pounding or racing. Usually these sensations are felt in your chest. Some people also feel them in their neck or throat.
If your palpitations are common types caused by PACs or PVCs, you may feel:
- As if your heart “skipped” a beat, followed by a strong heartbeat (as if the heart stopped briefly, then restarted).
- One or 2 strong “thumps” in the heart.
- Light-headed or woozy for a second.
These symptoms can be more noticeable when you:
- Are lying down at night.
- Have just finished a meal.
- Are sitting quietly.
People with PACs or PVCs probably have them throughout the day without noticing. They’re usually harmless, though possibly annoying.
Less common symptoms may signal a heart problem. One worrisome symptom is fast-paced heartbeats that also:
- Occur one right after another, in a row (not just one beat).
- Have a regular or irregular rhythm.
- Last for a few moments or continue for many minutes or hours.
Call 911 or go to the nearest hospital if you have palpitations along with any of these symptoms:
- Chest pain
- Feeling faint or dizzy
- Breathing difficulty
- Sweating, especially “cold sweat”
- Feeling confused or disoriented
- Tightness or pain in the back, neck, stomach, or jaw
These symptoms can signal a serious heart condition or a medical emergency.
Causes
Various conditions can cause heart palpitations.
If you have common palpitations, several factors can make your symptoms stronger. These include:
- High stress and anxiety
- Pregnancy
- Overuse of stimulants, such as caffeine from coffee, tea, cola, and chocolate
- Overuse of alcohol
- Smoking tobacco or marijuana
- Overactive thyroid gland
- Medications, such as pseudoephedrine (Sudafed), or albuterol asthma inhalers (not steroid types)
If you have the less common fast-beat palpitations, you may have a heart arrhythmia. Several heart conditions can cause arrhythmias. We can determine whether you have one of these arrhythmias:
- Atrial fibrillation
- Supraventricular tachycardia
- Ventricular tachycardia
Palpitations can also be caused by digestive disorders, including:
- Simple indigestion
- Gastroesophageal reflux disease (GERD)
- Gallstones
Rarely, palpitations are caused by asthma or chronic obstructive pulmonary disease (COPD).
Diagnosis
During your checkup we’ll ask about your medical history, medications or supplements you’re taking, and symptoms. To help us understand your palpitations, we may ask:
- Do you feel fluttering, or a racing heartbeat?
- Does it feel like your heart skipped a beat?
- Does your heartbeat feel regular or irregular during palpitations? (Don't worry if you don’t know for sure.)
- How long do your palpitations usually last?
- Do palpitations usually occur at specific times of day, or after meals or other events? Do you notice a pattern?
- Do you have other symptoms along with heart palpitations?
We’ll also listen to your heart with a stethoscope. We’ll check for any irregularities in your heart rhythm.
We may ask you to track your palpitations. You’d write down when they occur, how long they last, exactly what they feel like, and any other symptoms.
If needed, we’ll recommend additional tests. These may include:
- Chest X-ray to check your heart’s size and structure.
- Electrocardiogram (EKG or ECG) to check your heart’s electrical activity.
- Holter or event monitor to evaluate your heart’s rhythm. You wear this device for 24 hours or up to several weeks.
- Blood tests to detect low blood count (anemia), thyroid problems, or abnormal levels of electrolytes (minerals, such as sodium and potassium, in the blood).
Treatment
Treatment depends on the cause of your palpitations.
If your test results show an abnormal blood count, thyroid, or electrolyte level, we treat that first.
Palpitations due to PACs or PVCs aren’t dangerous. We’ll talk about why they occur.
If you have this palpitation type, you may be able to reduce symptoms by:
- Avoiding substances like caffeine, alcohol, or decongestants.
- Using relaxation methods such as meditation or breathing (if your palpitations are linked to stress).
- Quitting smoking (if you smoke), including tobacco or marijuana. We can connect you with support if you want help with quitting.
- Eating a healthy, nutritious diet.
If you have a heart problem, we’ll talk about treatment options. This may include medications or surgery.
Additional References
Related Health Tools
Disclaimer
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.