Symptoms

Heart palpitations can feel like the heart is:

• Beating too fast
• Flip-flopping
• Fluttering rapidly
• Pounding
• Skipping beats

Heart palpitations may be felt in the throat or neck as well as the chest. They can occur during activity or at rest.

When to see a doctor

Palpitations that are infrequent and last only a few seconds usually don't need to be evaluated. If you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your health care provider. You may need heart-monitoring tests to see if the palpitations are caused by a more serious heart problem.

Seek emergency medical attention if heart palpitations occur with:

• Chest discomfort or pain
• Fainting
• Severe shortness of breath
• Severe dizziness

Causes

Often the cause of heart palpitations can't be found. Common causes include:

• Strong emotional responses, such as stress, anxiety or panic attacks
• Depression
• Strenuous exercise
• Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
• Fever
• Hormone changes associated with menstruation, pregnancy or menopause
• Too much or too little thyroid hormone

Occasionally heart palpitations can be a sign of a serious problem, such as an irregular heart rhythm (arrhythmia).

Arrhythmias might cause a very fast heartbeat (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rhythm or a combination of the three.

Risk factors

Risk factors for heart palpitations include:

• Stress
• Anxiety disorder or panic attack
• Pregnancy
• Certain medicines that contain stimulants, such as some cold or asthma medications
• An overactive thyroid gland (hyperthyroidism)
• Other heart problems, such as irregular heartbeats, structural heart changes, previous heart attack or previous heart surgery

Complications

For palpitations caused by a heart condition, possible complications may include:

• Fainting. If the heart beats rapidly, blood pressure can drop, causing the person to faint. This is more likely in those with a heart problem, such as congenital heart disease or certain valve problems.
• Cardiac arrest. Rarely, palpitations can be caused by life-threatening heartbeat problems and can cause the heart to stop beating effectively.
• Stroke. If palpitations are due to a condition in which the upper chambers of the heart quiver instead of beating properly (atrial fibrillation), blood can pool and cause clots to form. If a clot breaks loose, it can block a brain artery, causing a stroke.
• Heart failure. Certain arrhythmias can reduce the heart's pumping ability. Sometimes, controlling the rate of an arrhythmia that's causing heart failure can improve the heart's function

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