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School of Medicine
Heart palpitations describe the experience of feeling as though the heart is pounding or racing, that the heartbeat is irregular or rapid or that the heart is skipping beats. Palpitations can be felt in the chest, throat and neck.
Many experience palpitations at some point or another. They can be frightening, but they are not always dangerous.
Though not always a sign of a more serious condition, palpitations can sometimes represent an abnormal heart rhythm (arrhythmia), which does require medical attention and needs to be treated seriously.
When to Call an Ambulance
Call 911 if someone experiences palpitations and faints or loses consciousness—or if the palpitations are accompanied by chest pains, dizziness, unusual sweating or lightheadedness.
- Overexertion or exercise.
- Caffeine, alcohol, tobacco or diet pills.
- Overactive thyroid.
- Hormone changes associated with menstruation, pregnancy or menopause.
- Low blood pressure.
- Heart disease or heart valve abnormalities.
- Medications such as thyroid pills, cold medicines, asthma drugs, beta blockers for high blood pressure or heart disease, or anti-arrhythmics (medications for irregular heart rhythm).
You can also try to reduce risk factors for heart disease.
- Don’t smoke.
- Exercise regularly.
- Eat a low-fat, low-cholesterol diet.
If you do experience palpitations, it may be helpful to write down how often they occur, how long they last, your heart rate at the time of the palpitations and what you are feeling at the time. Presenting these symptoms and their frequency may help your physician diagnose the cause.
Diagnostic tests that may be performed include:
- Electrocardiogram. An ECG or EKG records the electrical activity of the heart and shows abnormal rhythms (arrhythmias or dysrhythmias).
- Ambulatory cardiac monitoring. A Holter monitor may be used for 24 hours. Other monitors may be worn in excess of two weeks.
- Echocardiogram. An “echo” uses ultrasound waves to produce a moving picture of the heart and heart valves.
- Coronary angiography. An X-ray of the heart’s blood vessels may be performed to evaluate possible narrowing of the coronary arteries, which can cause palpitations. In this procedure a tiny catheter is inserted into an artery of a leg or arm and threaded up into the coronary arteries. A contrast material is then injected from the end of the catheter into the coronary arteries, and X-rays are taken.
To manage palpitations, the underlying cause must be treated. Lifestyle changes that include a heart-healthy diet and regular exercise may be recommended. Avoiding stimulants such as caffeine or nicotine may also reduce the occurrence of palpitations.
In some cases, medications may also be prescribed.