Why do I get heart palpitations?

Palpitations can make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. Patients may notice heart palpitations in their chest, throat, or neck.

They can be frightening for patients and they usually aren’t serious or harmful and often go away on their own. Generally, they are caused by stress and anxiety, or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen in women when they are pregnant.

In rare cases, palpitations can be a sign of a more serious heart condition. If you have heart palpitations, it is important to see your doctor.

Get immediate medical attention if your palpitations come with:

After your doctor takes your medical history and gives you a check-up, they may want to order tests to find the cause of the palpitations. If they find a cause, the right treatment can reduce or get rid of the palpitations.

If there’s no underlying cause found then lifestyle changes can help, including stress management.

Causes

Usually, palpitations are either related to your heart or the cause is unknown. Non-heart-related causes include:

  • Strong emotions like anxiety, fear, or stress. They often happen during panic attacks.
  • Vigorous physical activity
  • Caffeine, nicotine, alcohol, or illegal drugs such as cocaine and amphetamines
  • Medical conditions, including thyroid disease, a low blood sugar level, anaemia, low blood pressure, fever, and dehydration
  • Hormonal changes during menstruation, pregnancy, or just before menopause. Sometimes, palpitations during pregnancy are signs of anaemia.
  • Medications, including diet pills, decongestants, asthma inhalers, and some drugs used to prevent arrhythmias (a serious heart rhythm problem) or treat an under active thyroid
  • Some herbal and nutritional supplements
  • Abnormal electrolyte levels
  • After eating heavy meals rich in carbohydrates, sugar, or fat.
  • Eating foods with a lot of monosodium glutamate (MSG), nitrates, or sodium can bring them on, too.

If you have heart palpitations after eating certain foods, it could be due to food sensitivity. Keeping a food diary can help you figure out which foods to avoid.

They can also be related to heart disease. When they are, they’re more likely to represent arrhythmia. Heart conditions tied to palpitations include:

At your consultation

During your consultation your doctor will:

  • Give you a physical exam
  • Take down your medical history
  • Want to know about your current medications, diet, and lifestyle
  • Ask for specifics about when, how often, and under what circumstances your palpitations occur

Sometimes they would offer you a blood test, this can help them find the cause of your palpitations.

Other useful tests include:

  • Electrocardiogram (ECG): This can be done while you’re at rest or exercising. The latter is called a stress EKG. In both cases, the test records your heart’s electrical signals and can find unusual heart rhythms.
  • Holter monitoring:You’ll wear a monitor on your chest. It continuously records your heart’s electrical signals for 24 to 48 hours. It can identify rhythm differences that weren’t picked up during an EKG.
  • Event recording: You’ll wear a device on your chest and use a handheld gadget to record your heart’s electrical signals when symptoms occur.
  • Chest X-ray: Your doctor will check for changes in your lungs that could come from heart problems. For example, if they find fluid in your lungs, it may come from heart failure.
  • Echocardiogram: This is an ultrasound of your heart. It provides detailed information about its structure and function.

If necessary, your doctor may refer you to a cardiologist for more tests or treatment.

Treatment for heart palpitations

Often, palpitations are harmless and go away on their own. In that case, no treatment is needed.

If your doctor doesn’t find a cause, they may advise you to avoid the things that might trigger the palpitations. Strategies may include:

  • Ease anxiety and stress
  • Cut out certain foods, beverages, and other substances.
  • Avoid medications that act as stimulants.

If your doctor finds a reason for your palpitations, they will focus on treating that reason.

If they’re caused by a medication, your doctor will try to find a different treatment.

If they represent an arrhythmia, you may get medications or procedures. You may also be referred to a heart rhythm specialist known as an electrophysiologist.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.