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 beats.

Palpitations are common and often normal. They are a symptom, not a disease. However, it is important to figure out what is causing them.

What is the cause?

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
• 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:

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

How are they diagnosed?

Your healthcare 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 prevent the palpitations. Talk with your healthcare provider about this.

How long will the effects last?

For some people palpitations last just a short time and the heart goes back to a normal rhythm on its own. If you keep having spells of palpitations, medicines to control heart rate may help keep you from having more spells, or you may have them less often.

If you have a medical problem that is causing palpitations, usually your heart rhythm will go back to normal with treatment of the underlying problem.

How can I take care of myself?

• Take the medicine prescribed and follow your healthcare 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 start suddenly or gradually and whether they stop suddenly or gradually. Note what you are doing and whether you notice any other symptoms when you have palpitations.
• Don’t smoke. Tell your provider if you need help quitting.
• Don't drink alcohol. Talk with your provider if you have problems with this.
• Keep a healthy weight. If you are overweight, talk to your provider about losing weight.
• Eat a healthy diet that is low in sodium and saturated and trans fat.
• Exercise regularly, according to your provider's advice.
• Learn to relax. Reduce stress and anxiety in your life.

Call your healthcare 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 healthcare provider can identify and treat.

How can I help prevent palpitations?

The best prevention is to have a heart-healthy lifestyle.

• Keep a healthy weight.
• Eat a healthy diet that is low in sodium and saturated and trans fat.
• Stay fit with the right kind of exercise for you.
• Decrease stress.
• Don’t smoke.
• Limit your use of alcohol.

If you have heart disease or high blood pressure, follow your healthcare provider's advice closely.