Heart Palpitations

Heart palpitations are sensations that your heart is pounding, fluttering, beating faster than normal, or skipping beats. You may feel them in your chest, throat, or neck. Short episodes that happen occasionally are usually benign, especially in otherwise healthy people.

Persistent or severe palpitations can be caused by arrhythmias (abnormal heart rhythms), thyroid problems, anemia, dehydration, or medication side effects. Identifying triggers helps determine whether you can manage them at home or need medical evaluation.

• Lifestyle factors: Stress, anxiety, panic attacks, lack of sleep
• Stimulants: Caffeine, nicotine, energy drinks, some cold medications
• Hormonal changes: Pregnancy, menopause, thyroid disorders
• Medical conditions: Anemia, fever, low blood sugar, heart valve problems
• Medications and substances: Decongestants, inhalers, illicit drugs
• Exercise or dehydration: Rapid heart rates during intense workouts or after fluid loss

1. Track Episodes:
   • Note timing, duration, and activities when palpitations occur
   • Record associated symptoms (dizziness, chest pain)
2. Limit Stimulants:
   • Reduce caffeine, nicotine, and alcohol
   • Check labels of cold medicines and supplements for stimulants
3. Hydrate and Balance Electrolytes:
   • Drink water throughout the day
   • Replenish electrolytes after exercise or illness
4. Stress Reduction:
   • Practice deep breathing, meditation, or yoga
   • Use grounding techniques during anxiety or panic attacks
5. Sleep and Routine:
   • Aim for 7–9 hours of sleep per night
   • Keep regular meal and exercise schedules
6. When Prescribed:
   • Take medications exactly as directed
   • Do not stop beta blockers or other heart medicines without medical advice

• Chest pain, pressure, or shortness of breath
• Dizziness, fainting, or near-fainting
• Palpitations following chest trauma
• Rapid heart rate (>150 beats per minute) that does not slow down

• Palpitations that occur frequently or last longer than a few minutes
• Palpitations accompanied by lightheadedness, fatigue, or swelling in legs
• New palpitations when you have heart disease, a pacemaker, or are pregnant
• Family history of sudden cardiac death or known arrhythmias

Your provider may recommend:

1. Physical exam and history: Review of symptoms, medications, caffeine/alcohol intake
2. Electrocardiogram (ECG): Measures heart rhythm at rest
3. Holter monitor or event monitor: Worn for 24 hours or longer to capture intermittent events
4. Blood tests: Check thyroid function, electrolytes, anemia, and infection markers
5. Echocardiogram: Ultrasound of the heart to assess valves and pumping function
6. Stress test: Evaluates heart rhythm during exercise if symptoms occur with activity

Treatment depends on the cause:

• Lifestyle changes: Reduce stress, avoid triggers, improve sleep
• Medication adjustments: Switching or stopping medicines that cause palpitations (under medical supervision)
• Treat underlying conditions: Managing thyroid disorders, anemia, or heart disease
• Antiarrhythmic medications or beta blockers: Prescribed when arrhythmias are confirmed
• Procedures: Catheter ablation or device implantation for certain heart rhythm disorders

Most palpitations are harmless and improve with lifestyle changes. However, persistent palpitations, especially with other symptoms, need medical evaluation to rule out serious heart rhythm issues.