When to Worry about Heart Palpitations

Heart palpitations are a common occurrence for many people, causing a fluttering sensation or a feeling of the heart racing or skipping. While they can be unsettling, they are often harmless and may happen because of various reasons like stress, caffeine intake, dehydration or strenuous exercise. However, there are times when heart palpitations may indicate a more serious underlying issue. Understanding degrees of seriousness for heart palpitations will help you better determine when to seek medical care.

What are Heart Palpitations?

Heart palpitations are sensations that make you feel like your heart is beating irregularly, too fast or too hard. You may notice a fluttering, pounding or racing sensation in your chest or neck during these episodes. Palpitations can occur randomly or be triggered by certain activities, emotions or substances. While they can be alarming, they're not always a sign of a serious problem.

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What do Heart Palpitations Feel Like?

Heart palpitations can manifest as a rapid fluttering sensation, as if your heart is racing or skipping beats. Some describe it as a pounding or thumping sensation in the chest. It's essential to pay attention to how often these sensations occur and if they coincide with other symptoms.

What Causes Heart Palpitations?

Several factors can trigger heart palpitations, including:

• Stress and Anxiety: High levels of stress or anxiety can stimulate the body's "fight or flight" response, leading to palpitations.
• Caffeine and Stimulants: Excessive intake of caffeine or stimulants like nicotine can increase heart rate and cause palpitations.
• Physical Activity: Intense physical activity, especially if you're not accustomed to it, can temporarily raise your heart rate and trigger palpitations.
• Medications: Certain medications, such as asthma inhalers, decongestants and some over-the-counter cold remedies, can cause palpitations as a side effect.
• Hormonal Changes: Hormonal fluctuations during menstruation, pregnancy or menopause can sometimes lead to palpitations.
• Medical Conditions: Underlying medical conditions such as thyroid disorders, electrolyte imbalances or heart problems like arrhythmias can cause palpitations.
• Dehydration: Dehydration and subsequent electrolyte imbalance can commonly cause heart palpitations, especially during the summer months.

When to Seek Medical Care for Heart Palpitations

While many cases of heart palpitations are harmless, there are instances where they may indicate a more serious issue with your heart. If you experience any of the following scenarios, it’s important to seek medical help immediately:

• Palpitations accompanied by chest pain, shortness of breath, dizziness, fainting or extreme fatigue.
• Palpitations that persist for an extended period, especially if they occur frequently or disrupt your daily activities.
• Palpitations accompanied by other symptoms such as nausea, sweating or pain radiating to the arm, neck, or jaw.
• Palpitations in individuals with a history of heart disease, high blood pressure, diabetes or other risk factors for cardiovascular problems.
• History of palpitations with episodes of brief vision changes, speech disturbances or numbness, and/or tingling on one side of the body.

If you're unsure whether your palpitations are cause for concern, it's always better to err on the side of caution and seek medical advice. Your cardiologist at CHI Saint Joseph Health can evaluate your symptoms, perform any necessary tests or screenings, and provide guidance on the most appropriate course of action. Remember, early detection and intervention are key to preventing serious complications and maintaining a healthy heart.

Diagnosing Heart Palpitations

Diagnosing heart palpitations involves a comprehensive evaluation to determine the underlying cause of the irregular heartbeats. Here’s a breakdown of the diagnostic process:

Medical History and Physical Examination:

• Medical History: Your doctor will start by asking about your symptoms, including when the palpitations occur, how often they happen, and if you have any associated symptoms such as chest pain, shortness of breath, dizziness or neurological changes. They will also inquire about your medical history, including any existing heart conditions, medications you’re taking and lifestyle factors such as caffeine or alcohol consumption.
• Physical Examination: A thorough physical examination will be conducted to check for signs of underlying conditions that could be causing the palpitations. This may include measuring your blood pressure, listening to your heart and lungs and checking for signs of swelling or fluid retention.

Diagnostic Tests:

Depending on the information gathered from your medical history and physical examination, your doctor may recommend one or more of the following tests to further evaluate your heart health:

1. Electrocardiogram (ECG or EKG): An ECG records the electrical activity of your heart and can detect abnormalities in the heart's rhythm and structure. This non-invasive test is often the first step in evaluating palpitations.
2. Holter Monitor: A holter monitor is a non-invasive device attached to a sticker that can record your heart rhythm 24 hours a day. A holter monitor is typically worn for 7-28 days depending on how frequent the palpitations are occurring. 
3. Echocardiogram: An echocardiogram uses sound waves to create images of your heart's structure and function. It provides valuable information about the size, shape and movement of your heart muscles and valves, helping to identify structural abnormalities or problems with blood flow.
4. Stress Test: A stress test, also known as an exercise stress test or treadmill test, evaluates how your heart responds to physical activity. During the test, you’ll be asked to walk on a treadmill or pedal a stationary bike while your heart rate, blood pressure and ECG are monitored. This test can help detect underlying heart conditions that may trigger palpitations during exertion.
5. Blood Tests: Blood tests may be ordered to check for conditions such as thyroid disorders, electrolyte imbalances or cardiac enzymes that could contribute to palpitations.
6. Electrophysiological Study (EPS): In some cases, particularly if you have frequent or severe palpitations, your doctor may recommend an EPS. During this invasive procedure, thin, flexible wires (electrodes) are threaded through blood vessels to your heart to record its electrical activity and identify the source of abnormal rhythms.

Managing Heart Palpitations

If you experience occasional palpitations without any other concerning symptoms, there are several steps you can take to help manage them:

• Reduce Stress: Practice relaxation techniques such as deep breathing, meditation or yoga to help reduce stress and anxiety.
• Limit Stimulants: Cut back on caffeine, nicotine and other stimulants that can trigger palpitations.
• Stay Hydrated: Drink plenty of water throughout the day to maintain hydration levels and support heart health.
• Get Regular Exercise: Engage in regular, moderate exercise to help strengthen the heart and improve cardiovascular health.
• Maintain a Healthy Diet: Eat a balanced diet rich in fruits, vegetables, whole grains and lean proteins to support overall heart health.
• Monitor Symptoms: Keep a log of when palpitations occur, how long they last and any accompanying symptoms to share with your health care provider.

If you experience palpitations frequently, they last for an extended period, or are accompanied by concerning symptoms, don’t hesitate to reach out to a health care professional. By staying informed and proactive about your heart health, you can take the necessary steps to address any potential issues and ensure the well-being of your most vital organ. Remember, your heart deserves the best care possible, so listen to its signals and seek help when needed.

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Heart Palpitation FAQs

Is it normal to feel your heartbeat in your chest?

Feeling your heartbeat in your chest is usually normal, especially during stress, exercise or excitement. Occasional palpitations are common. However, if they're frequent, prolonged or accompanied by other symptoms like chest pain or dizziness, consult a health care professional.

When should you go to the ER for palpitations?

Go to the ER if palpitations come with severe chest pain, difficulty breathing, fainting or if they're prolonged and not relieved by rest. These could signal a serious cardiac condition like a heart attack or arrhythmia.

How to stop palpitations?

Try deep breathing, relaxation techniques, staying hydrated and avoiding triggers like caffeine and stress. Adopting a healthy lifestyle with exercise, a balanced diet and adequate sleep can help. If palpitations persist despite these measures or come with concerning symptoms, consult a health care professional.

How long do heart palpitations last?

Palpitations can last seconds to minutes and usually resolve on their own. Some may experience prolonged or recurrent palpitations lasting hours or days. If they persist or come with other symptoms, seek medical evaluation for proper diagnosis and treatment.