Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.
Have an unpleasant awareness of your own heartbeat
Feel like your heart skipped or stopped beats
The heart's rhythm may be normal or abnormal when you have palpitations.
Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing
Normally the heart beats 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 fast (over 100 beats per minute), this is called tachycardia. A slow heart rate is called bradycardia. An occasional extra heartbeat is known as extrasystole.
Palpitations are usually not serious. However, it depends on whether or not the sensations represent an abnormal heart rhythm (arrhythmia).
The following conditions make you more likely to have an abnormal heart rhythm:
Known heart disease at the time the palpitations begin
Significant risk factors for heart disease
An abnormal heart valve
An electrolyte abnormality in your blood -- for example, a low potassium level
Heart palpitations are most often not serious. They can be due to:
Anxiety, stress, panic attacks, or fear
Caffeine and nicotine use
Cocaine or other illegal drugs
However, some palpitations are due to an abnormal heart rhythm, which may be caused by:
Abnormal heart valve, such as mitral valve prolapse
Abnormal blood levels of potassium
Certain medications, including those used to treat asthma, high blood pressure, or heart problems
Low levels of oxygen in your blood
Reduce your caffeine and nicotine intake. This will often reduce heart palpitations.
Learn to reduce stress and anxiety. This can help prevent palpitations and help you better manage them when they occur.
Try breathing exercises or deep relaxation (a step-by-step process of tensing and then relaxing every muscle group in your body)
Practice yoga, meditation, or tai chi.
Get regular exercise.
Do not smoke.
Once a serious cause has been ruled out by your doctor, try not to pay close attention to heart palpitations. This may cause stress. However, contact your doctor if you notice a sudden increase or a change in them.
Call your health care provider if
If you have never had heart palpitations before, see your health care provider.
The following symptoms require immediate attention. Call 911 or your local emergency number:
Goldman L. Approach to the patient with possible cardiovascular disease. In Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 48.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.