Heart palpitations are a common experience, felt as a sudden awareness of your heartbeat, which may feel like a racing, pounding, fluttering, or skipped beat in the chest, throat, or neck. While this sensation can be unsettling and cause anxiety, most instances are brief and harmless, representing a normal response to various non-cardiac factors. The perception of an irregular rhythm does not always signify a serious underlying heart problem. Understanding when this sensation crosses the line into a medical concern requires distinguishing between temporary triggers and more serious accompanying symptoms.
Common Triggers That Cause Palpitations
Many people experience palpitations due to temporary, non-cardiac factors that increase the body’s adrenaline-like response. Strong emotional states like stress, anxiety, or panic attacks can trigger the sympathetic nervous system, causing the heart to beat faster and with greater force. The consumption of stimulants is another frequent cause, including caffeine, nicotine from smoking or vaping, and certain over-the-counter decongestant medications.
Changes in the body’s internal environment, such as dehydration or intense exercise, can also provoke this sensation. Hormonal fluctuations associated with the menstrual cycle, pregnancy, or menopause are well-documented triggers. These common, benign causes often result in palpitations that quickly resolve once the triggering factor is removed.
Immediate Warning Signs Requiring Emergency Care
The presence of accompanying symptoms alongside palpitations should immediately prompt emergency medical attention, as they may signal a severe cardiac event. Severe chest pain or discomfort, especially if it radiates to the jaw, neck, back, or arm, is an urgent symptom that may indicate a heart attack. Similarly, the sudden onset of severe shortness of breath that makes it difficult to speak warrants immediate care.
Fainting (syncope) or severe dizziness during a palpitation episode suggests the brain is not receiving adequate blood flow, often resulting from a dangerous heart rhythm. Palpitations that are sustained, lasting more than a few minutes, or are accompanied by profuse, unusual sweating also raise a serious concern. If these acute symptoms occur, calling emergency services is necessary because prompt medical intervention can be lifesaving.
Underlying Health Conditions Linked to Palpitations
When palpitations are not linked to temporary triggers or acute symptoms, they may point toward an underlying, chronic medical condition. Heart rhythm disorders, known as arrhythmias, are a common cause, where the heart beats too fast (tachycardia), too slow (bradycardia), or irregularly. Atrial Fibrillation (AFib), where the upper chambers of the heart quiver instead of beating effectively, is a frequent arrhythmia that causes palpitations and can increase the risk of stroke.
Structural heart issues, such as heart valve problems or cardiomyopathy (a disease of the heart muscle), can also manifest as palpitations. Several non-cardiac diseases can disrupt the electrical stability of the heart muscle, including hyperthyroidism, which accelerates heart rate. Imbalances in key electrolytes like potassium and magnesium, or conditions like iron deficiency anemia, can also directly influence the heart’s rhythm.
Diagnosis and Management Options
When seeking medical evaluation for concerning palpitations, the diagnostic process begins with a comprehensive history and physical exam. A healthcare provider often uses an Electrocardiogram (ECG or EKG) to capture the heart’s electrical activity at rest, checking for abnormal rhythms or signs of underlying damage. Since palpitations are often intermittent, an ambulatory monitor, such as a Holter monitor, may be worn for 24 to 48 hours to record the heart’s rhythm over a longer period.
Blood tests are routinely performed to check for non-cardiac causes, assessing thyroid hormone levels, blood count for anemia, and the concentration of key electrolytes. If a treatable cause is identified, management focuses on addressing that condition, such as adjusting thyroid medication or correcting an electrolyte deficiency. For heart-related diagnoses, treatment may involve lifestyle changes, prescription medications like beta-blockers, or specialized procedures such as ablation.