Palpitations can sometimes be frightful, especially if you have never experienced them. Fortunately, palpitations often are not a cause for concern. They most commonly occur at rest. Still, you should never ignore them, especially if you are at high risk of heart disease, as palpitations on rare occasions may be a sign of a more serious problem like valvular heart disease or hyperthyroidism (overactive thyroid).
This article discusses the symptoms and potential causes of palpitations and highlights the significant risk factors you need to be aware of.
Symptoms of Palpitations
Some people have palpitations every once in a while, while others have them more regularly. People experience different palpitation sensations but they typically are described as:
Feeling like your heart is skipping a beatFeeling like your heart is throbbing or flutteringA racing heartbeatA pounding sensation in the neck or chest
The symptoms of nausea, shortness of breath, or sweating may also accompany your palpitations.
Palpitations—if associated with low blood pressure or heart failure—can sometimes also cause you to feel faint or light-headed.
Causes of Palpitations
Palpitations are commonly triggered by fear, anxiety or stress, strenuous exercise, or consuming too much caffeine, but sometimes the cause is unknown. They usually go away on their own without any treatment and people learn to live with this abnormal heart rhythm.
The most common causes of palpitations are:
Stress or anxiety Strenuous activity Extreme fatigue Hormonal changes caused by pregnancy, menopause, or menstruation Caffeine Nicotine Alcohol Stimulant medications, including Sudafed 12 Hour (pseudoephedrine) Recreational drugs, such as cocaine, heroin, amphetamines, ecstasy, and cannabis Rich or spicy foods Pregnancy Dehydration Anemia Panic attacks Cardiomyopathy Hyperthyroidism Heart valve disease Other, more dangerous arrhythmias
What Medications Can Cause Palpitations
As previously mentioned, some recreational drugs like cocaine and amphetamines can cause heart palpitations. Others like pseudoephedrine have become tightly regulated since they have been shown to increase heart failure risk in vulnerable populations.
It’s important to know which medications can trigger palpitations so that you know this connection should you experience this symptom.
The following medicines can occasionally trigger palpitations:
Asthma inhalers containing salbutamol and ipratropium bromide High blood pressure (hypertension) medicines, such as hydralazine and minoxidil Antihistamines, such as terfenadine Antibiotics, such as Biaxin XL (clarithromycin) and erythromycin Antidepressants, such as Celexa (citalopram) and Lexapro (escitalopram) Antifungal medicines, such as Sporanox (itraconazole) Cough decongestants that include pseudoephedrine
It is always recommended that you consult your healthcare provider before reducing or stopping a prescribed medication. Never stop taking a prescribed treatment without first getting medical advice even if you believe that your medication is the cause of your heart palpitations.
How to Treat Palpitations
The specific treatment for your palpitations will depend on the cause of your symptoms. Most of the time, palpitations will go away on their own or may be resolved by doing the following:
Performing relaxation techniques such as yoga, meditation, and breathing exercisesCutting back on the offending medication (but first consult your healthcare provider before reducing any medication that is prescribed to you)Drinking more water Avoiding alcohol Cutting back on caffeine or spicy foodsGetting back to routine exercise
If the cause of your heart palpitations is due to thyroid problems, arrhythmias, atrial fibrillation, or another heart condition such as heart failure or valvular heart disease, you may need to take medications, surgery, or a pacemaker to correct your abnormal heart rhythm.
Therefore, if you experience heart palpitations and are at high risk of heart problems it is suggested that you contact a medical professional as soon as possible.
Are There Tests to Diagnose the Cause of Palpitations?
Most people don’t experience heart palpitations during a medical visit. Your healthcare provider will take a detailed history, asking you about your medications, lifestyle habits, and past medical history. They may also perform a focused physical exam, listening to your heart with a stethoscope for signs of an abnormal heartbeat or arrhythmia.
To determine what might be causing your heart palpitations, your healthcare provider may recommend or perform one of the following tests:
Blood tests: Blood tests may look at hormone (thyroid), electrolytes (potassium and sodium), and blood cell levels. Urine analysis: A urine test can detect stimulants that throw off the regular, steady pattern of the heart. A urine test measures catecholamine, electrolyte, blood cell, hormone, and blood sugar levels. Echocardiogram: This test uses ultrasound to create an image of the heart that describes the size, shape, and motion of the heart. Irregularities in any of these three components can lead to arrhythmias that may cause heart palpitations. Cardiac stress test: Also known as a treadmill test, this exam tracks your heart rate and rhythm while you walk or run on a treadmill or ride a stationary bicycle. Electrocardiogram (EKG): Detecting abnormalities on an EKG—a test involving attaching small electrodes to your chest to measure electrical impulses of the heart—is helpful in diagnosing cardiac causes of heart palpitations. Some heart conditions associated with palpitations that may be detected by EKG include arrhythmias and congestive heart failure. Of note, a Holter monitor is a portable EKG that can track your heart rhythm over the course of 24 hours. Chest X-ray (CXR): A CXR is a quick and inexpensive way to take a look at the anatomy of the heart and lungs.
Consult your healthcare provider if your test results are unclear or if you have any questions. After taking these exams you will likely meet with your healthcare provider who will explain the results and discuss your treatment options.
When to See a Healthcare Provider
Palpitations are usually not harmful, but they may be a cause for concern if they are associated with any of the following symptoms:
Holter monitors or long-term monitors which are prescribed by physicians Personal ECG monitors, such as Kardia and Apple Watch, which people can purchase on their own
Dizziness, confusion, or light-headednessChest pain or pressure (like someone is sitting on your chest)Difficulty breathingFainting (syncope) while having palpitationsPain, pressure or tightness in your chest, neck, jaw, arm(s), or upper backUnusual sweating
Get immediate medical attention if you have any of the aforementioned symptoms or if your palpitations are new, persistent, or getting worse.
Summary
Palpitations are a common symptom most often caused by a benign cardiac rhythm abnormality. They are usually harmless, but in rare cases, they may be a sign of a serious medical condition.
A Word From Verywell
Palpitations are often not a cause for concern. However, it’s best to let your healthcare provider know you are experiencing palpitations. Your provider can run tests to check for an underlying medical condition.
