Patient education: Palpitations (The Basics)

What are palpitations? — Palpitations are changes in your heartbeat that you can feel. You might feel like your heart is beating hard, beating fast, or skipping a beat. Some people describe the feeling as a fluttering or pounding in the chest, neck, or throat.

Most of the time, palpitations are not serious, and go away on their own. But sometimes, they are related to a heart condition that needs treatment.

What causes palpitations? — There are lots of possible causes. They include:

●Heart problems

●High blood sugar

●Stress, anxiety, or panic attacks

●Thyroid problems or other hormone disorders

●Certain medicines

●Pregnancy

●Exercise

●Fever

●Smoking, alcohol, caffeine, or other substances

Will I need tests? — Probably. If you have palpitations, your doctor or nurse can do several things to try to figure out the cause:

●They will do an exam and ask about your palpitations. They might ask how long you have had them, what they feel like, and when they happen. They might also ask whether things like exercise or changing positions make your palpitations better or worse.

●They will also ask about your health. This includes any other symptoms you have, medicines you take, or substances you use.

Your doctor or nurse will also do:

●An electrocardiogram ("ECG") – This test measures the electrical activity in your heart (figure 1).

Depending on your situation, you might get other tests, such as:

●Blood tests

●Echocardiogram – This is an imaging test. It creates pictures of your heart as it beats.

●Heart monitoring – This involves wearing a small, portable machine that records your heart's electrical activity.

How are palpitations treated? — Treatment depends on what is causing your palpitations. For example:

●If you have a heart problem, your doctor can prescribe medicines or suggest other treatments.

●If you have another health condition, such as diabetes, you might need to take medicines or make lifestyle changes.

●If your palpitations are related to a medicine you take, your doctor might switch the medicine or change your dose.

●If you have anxiety or panic attacks, your doctor or nurse can suggest treatments that can help.

Sometimes, palpitations go away on their own. This might happen if they were related to a temporary condition, like a fever.

Is there anything I can do on my own? — You can:

●Take all of your medicines as instructed.

●Avoid smoking. If you are having trouble quitting smoking, your doctor or nurse can help.

●Avoid or limit alcohol and caffeine.

●Try to get regular physical activity. Even gentle forms of activity, like walking, are good for your health. If exercise causes palpitations or other symptoms, talk to your doctor or nurse about what kinds of physical activity are safe to do.

●Find healthy ways to cope with stress.

When should I call the doctor? — Some heart problems can increase your risk of heart attack or stroke.

Call for an ambulance (in the US and Canada, call 9-1-1) if:

●You have signs of a heart attack. This might include severe chest pain, pressure, or discomfort with:

•Breathing trouble, sweating, upset stomach, or cold and clammy skin

•Pain in your arms, back, or jaw

•Worse pain with activity like walking up stairs

•Fast or irregular heartbeat

•Feeling dizzy, faint, or weak

●You have signs of a stroke, like sudden:

•Numbness or weakness of the face, arm, or leg, especially on 1 side of the body

•Confusion, or trouble speaking or understanding

•Trouble seeing in 1 or both eyes

•Trouble walking, dizziness, or loss of balance or coordination

•Severe headache with no known cause

Call your doctor or nurse for advice if:

●You notice new changes in your heartbeat.

●You have other new symptoms that worry you.

More on this topic

Patient education: ECG and stress test (The Basics)
Patient education: Ventricular premature beats (The Basics)
Patient education: Tachycardia (The Basics)
Patient education: Ventricular tachycardia (The Basics)
Patient education: Supraventricular tachycardia (SVT) (The Basics)
Patient education: Long QT syndrome (The Basics)
Patient education: Atrial flutter (The Basics)
Patient education: Atrial fibrillation (The Basics)
Patient education: Hypertrophic cardiomyopathy in adults (The Basics)
Patient education: Hyperthyroidism (overactive thyroid) (The Basics)
Patient education: Panic disorder (The Basics)
Patient education: Generalized anxiety disorder (The Basics)

Patient education: Atrial fibrillation (Beyond the Basics)
Patient education: Hypertrophic cardiomyopathy (Beyond the Basics)
Patient education: Hyperthyroidism (overactive thyroid) (Beyond the Basics)