— Michele, Massachusetts At some point in their lives, most people have heart palpitations, which are caused by a deviation from the normal heartbeat. Palpitations can range in severity from a mild fluttering to a pounding beat or even to a feeling that the heart has stopped, and they can be often linked to stimulants like caffeine (even the caffeine found in chocolate and cold remedies is sometimes problematic), nicotine use, or too much alcohol. But palpitations can also occur due to the hormonal changes related to pregnancy, menstruation, and the decreased estrogen levels associated with perimenopause and menopause. Some women who use hormone therapy to counteract menopausal symptoms (such as hot flashes and vaginal dryness) also complain of heart palpitations. Other possible causes include anxiety and stress, lack of sleep, and exercising too strenuously. Are you doing everything you can to manage your heart condition? Find out with our interactive checkup. In most people, heart palpitations are harmless (benign) and cause no damage to the heart itself. Nor do they represent underlying heart disease. In general, the palpitations improve when one of the above conditions or causes goes away. But if you are experiencing new symptoms of light-headedness, loss of consciousness, chest pain, or shortness of breath, or if you have a history of heart disease or a previous heart attack, you should discuss your symptoms with your doctor. A complete physical examination with blood tests, an electrocardiogram, and an echocardiogram should reveal any serious underlying problem. Q2. Sometimes I experience heart palpitations. What are they, and should I be worried? Palpitations are heartbeats that are noticeable because they feel fast or irregular. They are often described as a throbbing in the chest, throat, or neck; as rapid or racing heartbeats; or as skipped or stopped beats. There are many common culprits behind palpitations, including:
Vigorous exerciseCaffeine, nicotine, alcohol, cocaine, diet pillsAnxiety, stress, fearFeverOveractive thyroidAnemiaHyperventilationLow levels of blood oxygenMedication (for example, thyroid pills, asthma drugs, beta-blockers, antiarrhythmics)Mitral valve prolapseHeart disease
Palpitations are usually not serious but sometimes can be, depending on whether the sensations represent a significant abnormality in the rhythm of the heart. You are more likely to have a significant abnormal heart rhythm if you have:
Known heart disease at the time the palpitations beginSignificant risk factors for heart diseaseAn abnormal heart valveAn electrolyte abnormality — for example, low potassium
Factors such as gender and age can also play a role. For example, women who are premenstrual or in perimenopause often report episodes of palpitations, probably due to changes in hormone levels. Older people are more likely to report heart palpitations because of their increased risk of associated arrhythmias and heart disease. There are steps you can take to get palpitations under control: Try to eliminate situations and substances that are known to stimulate the heart. Getting plenty of rest and keeping well hydrated are important, too. And check with your doctor — you can help him or her determine why your palpitations occur and if they’re serious by keeping a record of how often you have them, when they happen, how long they last, your heart rate at the time, and any other symptoms you have. Your doctor will most likely do a workup to determine the cause and decide whether you need treatment. If you ever experience palpitations along with chest pain, troubled breathing, or light-headedness, call your doctor and/or 911 immediately. Learn more in the Everyday Health Heart Health Center.
