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Heart Palpitations

Is this your symptom?

  • A fluttering feeling in your chest
  • A thumping or pounding feeling in your chest

Causes of Palpitations

There are many causes of palpitations. The most serious causes can be life-threatening, but can often be treated with quick diagnosis and treatment. It is important to seek medical help right away if you get palpitations which do not end within a minute or two. Also, seek help right away if you start to feel dizzy, have chest pain or trouble breathing, or feel like you are going to pass out. Many causes of palpitations are less serious.

  • Heart Disease (serious). Heart disease is a common and important cause of palpitations. You might notice your pulse (heart rate) has changed if you are wearing a device such as a Fitbit. Abnormal heart beats are called arrhythmias. Some come and go and are harmless. Others are permanent unless treated. They can cause other problems such as clots forming in the heart. These clots can leave the heart and cause a stroke. You should seek help right away if you have palpitations and serious symptoms start to happen. Heart conditions that can cause arrhythmias include:
    • Heart attack and angina
    • Heart valve disease
    • High blood pressure
    • Age-related changes
    • Heart muscle disorders (cardiomyopathy)
    • Congenital heart problems
  • Pulmonary Embolus (serious). This occurs when a clot from somewhere in the body (often the legs) travels through the blood stream and gets trapped in the lungs. A large clot can quickly be life-threatening. Symptoms include breathlessness, chest pain and coughing up blood. There is often a fast heart beat and palpitations
  • Caffeine, alcohol and smoking. Too much caffeine or alcohol is a common cause. Smoking can also cause palpitations. Using less of these is often all that is needed. Sudden reduction can cause withdrawal symptoms, which may also include palpitations.
  • Medicines:
    • Medicines for ADHD can cause a fast heartbeat.
    • Illegal drugs, such as cocaine, can cause a fast heart rate.
    • Thyroxine, used to treat low thyroid, can cause a fast heartbeat and palpitations.
    • Beta blockers and Digoxin are medicines that are used to slow and/or manage the heart rate. If you don't take the right dose, the heart may become too slow and feel like palpitations.
  • Anemia is a condition where there are not enough red blood cells moving through the body or the red cells are not carrying enough oxygen. So, the heart has to work harder to push enough oxygen to the tissues. Once the cause of the anemia is found and treated, the palpitations should calm down.
  • Anxiety. Most people feel anxious from time to time. You may feel fearful or tense, but you may also feel symptoms such as dry mouth, sweating or shaking. You may also have palpitations (feel like your heart is racing). Some people mistake these symptoms for anxiety. But, if you feel anxious and you can’t think what you are anxious about, try checking your pulse or speak to your doctor. Treatment or control of the anxiety will help the palpitations disappear.
  • Fever. Heart rate is often higher if you have a fever, so you may feel palpitations. The most common cause of fever is infection. But, other conditions can cause your temperature to rise. Treatment of the cause will help calm the palpitations.
  • Dehydration, fluid or blood loss. These lead to a less than normal amount of blood flowing through your body. The heart beats faster to make up for this and you may feel palpitations. Treatment of the cause will help the palpitations to calm down.
  • Overactive Thyroid (hyperthyroidism) is a condition in which the thyroid gland produces too much thyroxine. It can make your heart beat race. You will lose weight in spite of having a bigger appetite. You may also sweat and feel weak. There may be changes in the appearance of your eyes. Treatment may be with medicines, radiotherapy and/or surgery.
  • Underactive Thyroid (hypothyroidism) is the opposite of an overactive thyroid. It causes bodily functions to slow down. The pulse rate will be slow and that may feel like palpitations. Treatment is with thyroxine tablets. But if too much is given the effect is the same as having an overactive thyroid.
  • Pregnancy. There are many different reasons why you may get palpitations in pregnancy. These include high blood pressure, low blood pressure, bleeding, dehydration, pain and anemia. Also, as pregnancy advances, the mother's blood volume is increased and the heart has to work harder to circulate the blood. The pulse is often faster and this may feel like palpitations. Call your doctor if you are pregnant and have palpitations.

When to Call for Heart Palpitations

When to Call for Heart Palpitations

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak)
  • Chest pain or pain that goes into the neck, jaw or arm
  • Passed out (fainted) or feeling like you might pass out
  • Confusion
  • Bluish lips or face or you appear very pale
  • Severe sweating
  • A tearing feeling in the chest, abdomen or back
  • Not moving or too weak to stand
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • You have known heart disease
  • Trouble breathing, but not severe
  • Fever or chills; feeling hot or shivery
  • Your heart is beating very fast (pounding heart felt or rapid pulse), but you don't feel ill
  • Your heart is beating very slowly, but you don't feel ill
  • Your heart is not beating with a steady rhythm. It may feel like there are extra beats or missed beats, but you don't feel ill.
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You feel well, but you have had more than 1 bout of palpitations within the past 24 hours
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Palpitations go away within a minute or two and there are no other symptoms
  • Palpitations cause is known, such as you drank too much caffeine or have anxiety. Follow the treatment plan you have been given.

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak)
  • Chest pain or pain that goes into the neck, jaw or arm
  • Passed out (fainted) or feeling like you might pass out
  • Confusion
  • Bluish lips or face or you appear very pale
  • Severe sweating
  • A tearing feeling in the chest, abdomen or back
  • Not moving or too weak to stand
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • You have known heart disease
  • Trouble breathing, but not severe
  • Fever or chills; feeling hot or shivery
  • Your heart is beating very fast (pounding heart felt or rapid pulse), but you don't feel ill
  • Your heart is beating very slowly, but you don't feel ill
  • Your heart is not beating with a steady rhythm. It may feel like there are extra beats or missed beats, but you don't feel ill.
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You feel well, but you have had more than 1 bout of palpitations within the past 24 hours
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Palpitations go away within a minute or two and there are no other symptoms
  • Palpitations cause is known, such as you drank too much caffeine or have anxiety. Follow the treatment plan you have been given.

Care Advice for Mild Palpitations that Go Away Quickly

  1. What You Should Know About Palpitations:
    • Palpitations are the feeling of your heart is beating differently. They are common.
    • They may feel like:
      • a fluttering or thumping feeling in your chest
      • you feel anxious, even if there is nothing you are anxious about
      • your heart is beating faster or slower than normal
      • your heart is missing beats or putting extra beats in.
    • If you know how to check your heart rate (also called pulse), it may help to find out how fast or slow it is. Some devices, such as a Fitbit, may tell you what your heart rate is. Your doctor will be able to show you how to check your own heart rate.
    • Some changes in heart rate and rhythm are normal during sleep, activity and moments of stress.
    • Palpitations that last for a few seconds or minutes are usually harmless. But, if they do not go away quickly, or you get them often, you should get checked out by your doctor.
    • If you have bouts of palpitations often, record your heart rate, how long the palpitations last and how long it is between bouts.
    • Here is some care advice that should help.
  2. What to Expect:
    • Most palpitations are harmless.
    • There are many different causes of palpitations. Most can be treated once the cause is known.
    • Your doctor will examine you and do tests to find out why you are getting them.
    • Do NOT delay seeking help if you have palpitations along with other symptoms such as dizziness, chest pain or trouble breathing.
  3. Checking Your Own Pulse (Heart Rate):
    • By checking your pulse, you can tell whether you have a fast or slow heart rate. You can also check whether your pulse is regular or not regular (irregular). An irregular pulse could be a sign of a heart problem.
    • The easiest place to check your pulse is at your wrist:
      • Put one of your hands out so you’re looking at your palm.
      • Use the first finger (your index finger) and middle finger of your other hand. Place the pads of these fingers on the inside of your wrist, at the base of your thumb.
      • Press lightly and feel your pulse. If you can’t feel anything, press slightly harder.
    • Once you’ve found your pulse, continue to feel it for about 30 seconds. Check to see if the beats feel regular or irregular.
    • You can work out your heart rate in beats per minute (bpm) by:
      • counting the number of beats for 60 seconds, or
      • counting the beats for 6 seconds and multiplying by 10.
    • If your pulse feels irregular, you should check for a full 60 seconds.
  4. Palpitations with Known Cause:
    • You may already be getting treatment for the cause of your palpitations.
    • Follow the advice your doctor has given you about what to do if the palpitations come back.
    • This could be cutting back on caffeine or alcohol.
    • If your palpitations are from anxiety, try to use advice you know will help you to relax.
    • Some palpitations for fast heart rates are helped by massaging the neck. Only do this if your doctor has shown you how to do it.
    • If the advice you have been given does not work, speak to your doctor.
    • Do NOT delay seeking help if you have palpitations along with other symptoms such as dizziness, chest pain or trouble breathing.
  5. Call Your Doctor If:
    • Your pulse (heart rate) becomes irregular
    • Palpitations happen often, even if they go away quickly
    • Palpitations are happening more often or last longer than normal
    • Your usual self-care actions do not help
    • You have other symptoms, such as a fever
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Decision Logic LLC and Self Care Decisions, LLC.

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