Heart palpitations

Heart palpitations (pal-pih-TAY-shuns) are feelings of having a fast-beating, fluttering or pounding heart. Stress, exercise, medication or, rarely, a medical condition can trigger them.

Although heart palpitations can be worrisome, they're usually harmless. Rarely, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

Heart palpitations can feel like the heart is:

• Beating too fast
• Flip-flopping
• Fluttering rapidly
• Pounding
• Skipping beats

Heart palpitations may be felt in the throat or neck as well as the chest. They can occur during activity or at rest.

Palpitations that are infrequent and last only a few seconds usually don't need to be evaluated. If you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your health care provider. You may need heart-monitoring tests to see if the palpitations are caused by a more serious heart problem.

Seek emergency medical attention if heart palpitations occur with:

• Chest discomfort or pain
• Fainting
• Severe shortness of breath
• Severe dizziness

Often the cause of heart palpitations can't be found. Common causes include:

• Strong emotional responses, such as stress, anxiety or panic attacks
• Depression
• Strenuous exercise
• Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
• Fever
• Hormone changes associated with menstruation, pregnancy or menopause
• Too much or too little thyroid hormone

Occasionally heart palpitations can be a sign of a serious problem, such as an irregular heart rhythm (arrhythmia).

Arrhythmias might cause a very fast heartbeat (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rhythm or a combination of the three.

Risk factors for heart palpitations include:

• Stress
• Anxiety disorder or panic attack
• Pregnancy
• Certain medicines that contain stimulants, such as some cold or asthma medications
• An overactive thyroid gland (hyperthyroidism)
• Other heart problems, such as irregular heartbeats, structural heart changes, previous heart attack or previous heart surgery

For palpitations caused by a heart condition, possible complications may include:

• Fainting. If the heart beats rapidly, blood pressure can drop, causing the person to faint. This is more likely in those with a heart problem, such as congenital heart disease or certain valve problems.
• Cardiac arrest. Rarely, palpitations can be caused by life-threatening heartbeat problems and can cause the heart to stop beating effectively.
• Stroke. If palpitations are due to a condition in which the upper chambers of the heart quiver instead of beating properly (atrial fibrillation), blood can pool and cause clots to form. If a clot breaks loose, it can block a brain artery, causing a stroke.
• Heart failure. Certain arrhythmias can reduce the heart's pumping ability. Sometimes, controlling the rate of an arrhythmia that's causing heart failure can improve the heart's function.