Is Your Heart Skipping a Beat? Let’s Talk About Palpitations
Many people experience a fast heartbeat or a racing sensation in the chest, commonly described as a “fluttering heart.”
The medical term for this sensation is palpitations. It refers to the feeling of having a fast heartbeat, pounding heartbeat, or an irregular heartbeat that may sometimes also be felt in the neck or throat.
A normal heart rate typically ranges between 60 and 100 beats per minute. However, this can vary from person to person based on factors such as fitness level, age, sex, chronic illness, or anxiety.
Palpitations are a very common reason for visits to emergency rooms and hospitals because they can often be frightening.
Let’s explore some of the causes of palpitations and when you should seek medical attention.
Causes of Palpitations
Palpitations may occur due to both benign (usually harmless) causes and non-benign or pathological conditions that may indicate a more serious underlying illness.
Benign Causes
Palpitations are often harmless and may be triggered by several factors, including:
- Anxiety, fear, emotional stress, or exposure to stressful environments or situations.
- Strenuous physical activities such as swimming, cycling, or running.
- Certain medications, including over-the-counter cold and cough medicines that contain pseudoephedrine. Other medications that may trigger palpitations include asthma medications, certain antibiotics, and thyroid medications.
- Recreational drugs such as cocaine and marijuana.
- Certain foods and drinks, including caffeinated beverages, energy drinks, and foods high in fat or processed ingredients.
- Fever, as palpitations can occur as part of the body’s normal response during illnesses such as the flu or common cold.
- Hormonal changes during pregnancy or menopause, which may cause intermittent palpitations in some women.
Non-Benign Causes
Some medical conditions associated with palpitations include:
Cardiac Conditions
- Arrhythmias (abnormal heart rhythms)
- Heart failure
- Heart valve disease
- Pericarditis (inflammation surrounding the heart)
Non-Cardiac Conditions
- Anaemia (low haemoglobin)
- Hyperthyroidism
- Hypoglycaemia (low blood sugar levels)
- Lung diseases such as chronic obstructive lung disease
When Should You Visit a Healthcare Provider?
You should seek medical attention if you experience palpitations along with any of the following high-risk features or “red flags”:
- Dizziness, fainting, or blackout spells.
- Chest pain, tightness, or a squeezing discomfort in the chest.
- Frequent or prolonged episodes of palpitations without a clear trigger.
- Palpitations that worsen at night or occur during physical activity.
- A history of unexplained sudden death in a close family member (such as a parent or sibling) before the age of 35, especially if they experienced fainting or palpitations.
- A known history of heart disease, including a prior heart attack, heart failure, or arrhythmias such as atrial fibrillation (fast and irregular heartbeat).
What’s Next?
Identifying the cause or trigger of palpitations is the first step in preventing future episodes. Treatment is largely based on addressing the underlying cause.
Things You Can Do
Helpful strategies include:
- Keeping a diary of when palpitations occur, including how you were feeling, any associated symptoms, foods or drinks consumed, medications taken, and use of herbal supplements.
- Practicing stress reduction techniques such as calm breathing exercises (inhale slowly, hold your breath for five seconds, then exhale fully and repeat), meditation, listening to calming music, and getting adequate sleep.
- Limiting foods and drinks that contain caffeine, such as coffee, green tea, and energy drinks (including caffeinated or ginseng-based drinks).
- Staying hydrated during exercise and during illnesses such as the common cold.
- Avoiding lying down immediately after eating, especially if you have heartburn or gastric reflux disease.
- Limiting alcohol consumption and avoiding recreational drugs.
Medical Evaluation and Testing
If red flag symptoms are present, your healthcare provider may order tests such as:
- An electrocardiogram (ECG) to analyze your heart rhythm
- Basic blood tests
- Thyroid function testing
In cases where an abnormal heart rhythm or cardiac cause is suspected, you may be referred to a cardiologist. The cardiologist may perform a thorough history and physical examination and may recommend additional testing, including:
- Prolonged heart rhythm monitoring with a Holter monitor
- An echocardiogram
- An electrophysiology study, in some cases, to identify abnormal heart rhythms and potentially eliminate them through ablation therapy
Final Thoughts
Palpitations are a very common symptom and are usually harmless. However, they can sometimes be caused by underlying medical conditions that require further investigation and treatment.
If your palpitations are frequent, concerning, or associated with any red flag symptoms, the first step is to visit your local health centre or district hospital for further evaluation.
