Heart Palpitations

Heart palpitations are the sensations that your heart is racing, pounding, fluttering, or missing a beat. While usually harmless, they can be an indication of abnormal heart rhythm.

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Heart palpitations feel like your heart is pounding or racing. They can occur even when you’re resting.

Because you normally do not notice your heartbeat, heart palpitations can be alarming. However, heart palpitations are among the most common heart-related symptoms that people report. They're usually harmless episodes that come and go.

If you have a known heart condition such as an irregular heartbeat or heart disease and are experiencing heart palpitations, they may be an indication of an underlying—and potentially serious—heart rhythm disorder.

At University of Iowa Heart and Vascular Center, our cardiac electrophysiologists can treat your underlying heart condition and relieve your symptoms. Home to the state’s largest and most experienced team of arrhythmia specialists, our providers will find a treatment plan that works for you, including treatment options not available anywhere else in the state.

Heart palpitation symptoms

Heart palpitations are often described as feeling like your heart is racing, pounding, skipping a beat or having an extra beat, flip-flopping, or fluttering. These can be felt in your chest, neck, and throat.

Sometimes patients report a general sense of uneasiness, shortness of breath, lightheadedness, or a loss of consciousness accompanying heart palpitations.

While heart palpitations are usually harmless, they can be a symptom of a more serious heart condition if you have a history of heart problems or have been told you have a significant risk for heart disease.

Heart palpitation causes

Many things can cause heart palpitations, including:

Caffeine
Alcohol
Anxiety, stress, panic, or other strong emotions
Recreational drugs, such as methamphetamine or cocaine
Nicotine
Decongestant medications, such as cold and allergy medications
Herbal supplements
Exercise
Dehydration
Medications used to treat asthma, high blood pressure, arrythmias, or other heart problems
Pregnancy

However, certain underlying conditions can also cause heart palpitations. These include:

Heart disease, including heart rhythm disorders
Heart valve defects
Overactive thyroid
Low levels of oxygen in your blood
An electrolyte imbalance

Heart palpitation diagnosis

Your evaluation will begin with a physical examination, a review of your medical history, and a discussion about your current lifestyle, including what you eat and drink and what medications or supplements you take.

Because most heart palpitations are harmless and not due to any serious condition, a thorough evaluation is enough to rule out any underlying issues.

If your symptoms are more severe, such as significant lightheadedness or loss of consciousness associated with palpitations, a more comprehensive evaluation is warranted. This type of evaluation may involve:

An ultrasound of the heart
A treadmill stress test
Additional blood tests, including thyroid tests
An ambulatory EKG or Holter monitor

Some patients may require invasive studies if a serious heart condition is suspected of causing palpitations.

Treatments for heart palpitations

If your heart palpitations are not caused by an underlying condition, you can reduce your instances of heart palpitations by:

Lowering your intake of caffeine, nicotine, and alcohol

Reducing your stress and anxiety as much as possible

Learning deep relaxation techniques such as breathing exercises, yoga, meditation, or tai chi

Getting regular exercise

For patients with more serious heart rhythm disorders, an electrophysiologist will perform several diagnostic tests to determine the cause of the arrhythmia. Once the disorder is identified, the electrophysiologist will work with you to create a care plan that meets your needs. This may include medications, lifestyle changes, procedures, and/or implanted devices to correct the problem.

A team approach to heart palpitations

If your heart palpitations are due to an abnormal heart rhythm or another underlying heart condition, our electrophysiologists will collaborate with a range of specialists, including cardiologists and surgeons, to provide a comprehensive treatment plan tailored to your needs.