Heart palpitations

Definition

Palpitations are heartbeat sensations that feel like your heart is pounding or racing. You may simply have an unpleasant awareness of your own heartbeat, or may feel skipped or stopped beats. The heart's rhythm may be normal or abnormal. Palpitations can be felt in your chest, throat, or neck.

See also: Arrhythmia

Alternative Names

Considerations

Normally the heart beats between 60-100 times per minute. In people who exercise routinely or take medications that slow the heart, the rate may drop below 55 beats per minute.

If your heart rate is very fast (over 100 beats per minute), this is called tachycardia. An unusually slow heart rate is called bradycardia. An occasional extra heart beat is known as extrasystole.

Palpitations are often not serious. However, it depends on whether or not the sensations represent an abnormal heart rhythm ( arrhythmia). You are more likely to have an abnormal heart rhythm if you have:

• Known heart disease at the time the palpitations begin
• Significant risk factors for heart disease
• An abnormal heart valve
• An electrolyte abnormality -- for example, low potassium

Causes

Heart palpitations can be caused by:

• Exercise
• Anxiety, stress, fear
• Fever
• Caffeine, nicotine, cocaine, diet pills
• Overactive thyroid
• Anemia
• Hyperventilation
• Low levels of oxygen in your blood
• Medications such as thyroid pills, asthma drugs, beta blockers, or anti-arrhythmics. (Medications to treat an irregular heart rhythm will sometimes cause a different irregular rhythm).
• Mitral valve prolapse, a condition in which the valve that separates the left upper chamber (atrium) from the left lower chamber (ventricle) of the heart does not close properly
• Heart disease

References

Mayou R, Sprigings D, Birkhead J et al. Characteristics of patients presenting to a cardiac clinic with palpitation. QJM. 2003; 96(2):115-123.