Heart flutters are a common sensation, medically termed heart palpitations, which involve a heightened awareness of one’s own heartbeat. This is the perception of an irregular or forceful cardiac action. While the sensation can be alarming and is often felt in the chest, it may also be noticeable in the neck or throat. Understanding this perception is important because, although frequently harmless, it can occasionally signal an underlying issue that requires medical attention.
The Subjective Experience of Cardiac Flutters
The experience of a heart flutter is highly subjective and can manifest in several distinct ways. One of the most frequently reported sensations is that the heart has “skipped a beat,” often followed by a noticeable, hard thump or pound. This thumping sensation results from the heart making up for the pause by contracting more forcefully to move the increased blood volume in the chamber.
A feeling of rapid, irregular movement, sometimes described as a “fluttering in the chest” or a “flip-flop” sensation, is another common description. This specific feeling is often likened to a fish flipping inside the chest cavity. Other people report a generalized awareness of their heart “racing” or beating very fast, even when they are at rest, which is known as tachycardia.
The sensation can be brief, lasting only a few seconds, or it may persist for minutes. It is frequently more noticeable when a person is lying down or resting, especially on the left side where the heart is closer to the chest wall. While the physical manifestation is harmless in most cases, the resulting fear or anxiety can amplify the perceived intensity.
Common Triggers and Physiological Causes
The irregular sensations associated with flutters arise from disruptions to the heart’s electrical system. The underlying mechanism is often an extra or premature beat, such as a premature atrial contraction (PAC) or a premature ventricular contraction (PVC). These extra beats interrupt the normal, steady pacing and are typically the most common cause of the “skipped beat” feeling.
Lifestyle and External Triggers
Stress and anxiety are frequent non-cardiac causes because intense emotions trigger the release of stress hormones like adrenaline. Adrenaline is a powerful stimulant that increases the heart rate and the force of contraction, leading to a racing heart or pounding sensation. Stimulants, such as caffeine, nicotine from tobacco products, and certain over-the-counter cold medicines containing pseudoephedrine, can also directly increase the heart’s excitability.
Heavy exercise is another common trigger, as a vigorous workout naturally increases the heart rate to pump more blood. Dehydration can prompt flutters by causing the blood to become thicker, forcing the heart to work harder to circulate it. Certain prescription medications, including those for asthma or thyroid replacement therapy, may also list palpitations as a known side effect.
Underlying Physiological Factors
Internal physiological states can also create an environment conducive to heart flutters. Hormonal fluctuations are a notable factor, with many women reporting palpitations during menstruation, pregnancy, or perimenopause due to changing estrogen levels. Imbalances in electrolytes—minerals like potassium, sodium, and magnesium that regulate the heart’s electrical signals—can cause an irregular rhythm.
Conditions affecting metabolism, such as an overactive thyroid gland (hyperthyroidism), can cause the heart to beat too quickly or irregularly. Low blood sugar (hypoglycemia) prompts a flutter response as the body releases adrenaline to compensate for the lack of glucose. Anemia, where a lack of red blood cells forces the heart to pump faster to deliver oxygen, can also be a root cause.
Recognizing Serious Symptoms and When to Consult a Doctor
While most heart flutters are harmless and temporary, certain accompanying symptoms suggest the palpitations may be related to a more serious underlying cardiac condition. It is important to seek medical attention if the flutters are frequent, worsening, or last for more than a few minutes. The presence of specific “red flag” symptoms requires immediate evaluation to rule out life-threatening issues.
If heart flutters are experienced, immediate medical care is warranted if they are accompanied by:
- Chest pain, particularly if it lasts more than a few minutes.
- Shortness of breath or difficulty breathing.
- Dizziness, severe lightheadedness, or fainting (syncope).
- Unexplained fatigue or unusual sweating.
Individuals who have a known pre-existing heart condition, or a family history of sudden cardiac death, should also consult a doctor promptly if they notice a change in the frequency or nature of their palpitations. These accompanying symptoms increase the possibility that the flutters are a manifestation of a serious arrhythmia or structural heart issue.
Medical Evaluation and Lifestyle Adjustments
When a medical professional is consulted, the evaluation process begins with a detailed history of the symptoms and a physical exam, including listening to the heart. The primary diagnostic tool is an electrocardiogram (ECG), which records the heart’s electrical activity and can capture an irregular rhythm if the flutter is occurring at the time of the test. If the flutters are intermittent, a portable heart monitor, such as a Holter monitor or an event recorder, may be worn for 24 to 48 hours or longer to catch the transient event.
Blood tests are also commonly performed to check for non-cardiac causes, including electrolyte imbalances, anemia, and thyroid issues. Once a serious cause is ruled out, management often focuses on actionable lifestyle changes that the patient can implement. Reducing or eliminating stimulants like caffeine, nicotine, and alcohol is a primary recommendation, as these substances can trigger and exacerbate flutters.
Management also involves improving sleep hygiene and reducing stress through techniques such as meditation, deep breathing exercises, or yoga. Ensuring adequate hydration and maintaining a balanced intake of electrolytes can help stabilize the heart’s electrical environment. These simple, non-pharmacological steps can often significantly decrease the frequency and intensity of heart flutters.