This blog was originally published in September, 2019.

Believing that something could be wrong with your heart is a scary feeling. Heart palpitations  can make you fear the worst, but palpitations are actually quite common and usually nothing to worry about.

However, that’s not to say that you should ignore them completely. Rarely, they could be a sign of a more serious condition like atrial fibrillation or AFib. Knowing when to worry about heart palpitations can help you catch certain conditions early so that you can seek the appropriate treatment option.

When to Worry About Heart Palpitations

Heart Palpitations occur for many reasons. You should contact your doctor if you experience heart palpitations frequently, for longer than a few seconds, or if they are accompanied by dizziness, loss of consciousness, chest or upper body pain, nausea, excessive or unusual sweating, and shortness of breath.

What are Heart Palpitations?

Have you ever felt your heart skip a beat or flutter in your chest? If so, you’ve experienced heart palpitations. A broad medical term, the term “palpitation” can mean many different things, including:

• Feeling like your heart is beating too quickly
• Feeling your heart thump in your chest
• A heartbeat that feels irregular/out of rhythm/skips a beat

Any sensation that makes you aware of your heart beating is a type of palpitation. You can even feel these sensations in your throat or neck.

Common Triggers

If you’re worried that your heart palpitations are the result of a heart problem, here’s some good news – most palpitations are not caused by heart-related issues. Instead, they are commonly triggered by:

• Exercise
• Stress/Anxiety
• Alcohol
• Stimulants (caffeine)
• Nicotine withdrawal
• Hormonal changes during pregnancy
• Low blood sugar

How to Reduce Heart Palpitations at Home

For the most part, palpitations caused by non-heart related triggers can be treated with simple home remedies.

For example, if you only feel your heart race when you’re anxious or stressed, relaxation techniques like meditation and deep breathing could be the key to reducing these palpitations. Finding your stress triggers and addressing them can also help you avoid palpitations in the future.

Likewise, a thumping heart caused by stimulant use can be calmed by reducing your intake of tobacco products and caffeine. If you’re taking any medication and experienced palpitations, tell your doctor. They can determine if your medication could be the cause.

Hydration and diet play a big role, too. Being dehydrated or having low levels of potassium can also trigger heart palpitations. If you have low blood sugar, eating too many carbohydrate-rich foods and processed sugars can increase your likelihood of experiencing palpitations.

When to See a Doctor

Nearly everyone will experience heart palpitations at some point. A majority of the time, they’ll be completely benign (not harmful). Other times, it could be your heart trying to tell you that something’s wrong.

You should call your doctor if your heart palpitations last longer than a few seconds at a time or occur frequently.

If you’re healthy, you don’t need to worry about brief heart palpitations that only happen every now and then. That being said, it’s still a good idea to monitor your palpitations and keep track of how often they happen and how long they last. They when, when you do visit your doctor, it will be easier for them to make an accurate diagnosis.

When to Call an Ambulance

If a person’s heart palpitations are accompanied by:

• Loss of consciousness
• Chest pain
• Upper body pain
• Dizziness
• Shortness of breath
• Unusual sweating
• Nausea

These are possible warning signs of a heart attack or other serious heart condition that requires immediate medical attention. Call 911 or your local emergency number – it’s always better to be safe than sorry.

Serious Causes of Heart Palpitations

Sometimes, heart palpitations are a sign of a serious type of arrhythmia (irregular heartbeat) such as atrial fibrillation (AFib) or ventricular tachycardia (VT), or even heart failure.

AFib

Atrial fibrillation, or AFib, is a common condition that causes the upper chambers of the heart (the atria) to quiver irregularly instead of beating at a regular pace. This makes it difficult for the heart to pump blood to your lower chambers (ventricles) and out to the rest of your body. As your blood flow slows down, your risk of forming dangerous clots increases.

Untreated, AFib can increase a person’s risk of stroke 5-fold, so recognizing the early warning signs is essential. However, because the disorder affects people in many ways, it can be challenging to diagnose. Most cases begin as occasional or paroxysmal. Since there is no predictable pattern of onset, a standard Electrocardiogram or EKG may miss the arrhythmia entirely. Specialized diagnostic tools used in our Cardiology department take longer-term measurements and are effective in diagnosing complex arrhythmias.

Common risk factors include:

• Age (adults 65+ are most at risk)
• High blood pressure
• A family history of AFib
• Hyperthyroidism (overactive thyroid)
• A history of heart disease or previous heart surgery

You should ask your doctor about testing for AFib if you:

• Have a high risk of AFib based on the factors above
• Experience fluttering heart palpitations that last longer than a minute at a time
• Have palpitations accompanied by dizziness/fainting/shortness of breath

When detected early, AFib can be treated with:

Medication: Anticoagulants, or blood-thinning medication, can reduce the risk of stroke. Drug therapy works in about 50% of patients. The other 50% may require further treatment to control their Afib due to potential side effects or declining medication effectiveness over time.

Ablation surgery: Cardiac catheter ablation is a minimally invasive procedure that threads a specialized catheter through a vein in the groin, arm, or neck and into the heart. During the procedure, targeted heat or cold therapy is used to ablate or destroy errant electrical signals of the heart, causing palpitations or arrhythmia.

Pacemaker: While a pacemaker does not treat Afib itself, it is often used for patients suffering from bradycardia (a slow heartbeat) or heart failure.

Ventricular Tachycardia

Ventricular tachycardia, or VT, is a rare but severe type of arrhythmia that causes the heart’s lower chambers (ventricles) to beat too quickly. Like AFib, VT can result in dizziness and shortness of breath. VT can be treated in several ways, including medications, cardioversion (electric shock to the heart), and cardiac catheter ablation.

Heart Failure

If the heart cannot pump blood effectively, heart failure can occur. Heart palpitations on their own are not a sign of heart failure – instead, they are just one of many symptoms that can occur. Some patients experiencing heart failure may not even experience palpitations at all.

According to the American Heart Association, some of the most common symptoms include:

• Fatigue
• Fluid build-up in the lungs
• Rapid heartbeat
• Loss of appetite
• Shortness of breath
• Confusion

However, keep in mind that heart failure symptoms vary from person to person, and women often experience different symptoms than men.

Don’t Panic (But Don’t Ignore the Signs, Either)

At the end of the day, most heart palpitations are as harmless as hiccups. If you are otherwise healthy and only experience them from time to time, you have no reason to panic.

However, while heart palpitations are usually not dangerous, it’s still in your best interest to get your symptoms checked by a cardiologist if the problem persists. And if your palpitations are accompanied by other symptoms, such as dizziness or weakness, it could be a sign of a more serious condition that shouldn’t be ignored.

Meet Dr. Andrea Tordini, Clinical Cardiac Electrophysiologist at Florida Medical Clinic Orlando Health

Still not sure when to worry about heart palpitations or what could be causing them?

As an abnormal heart rhythm specialist, Dr. Andrea Tordini helps patients in Tampa, Florida, relieve their symptoms and improve their quality of life. Dr. Tordini specializes in the management of abnormal heart rhythms. Her areas of expertise include: atrial fibrillation ablation and management, evaluation and management of syncope and symptoms related to slow heart rhythms, pacemaker and cardiac defibrillator implantation, as well as the management of heart failure through cardiac resynchronization therapy.

Dr. Andrea Tordini focuses on providing her patients with optimal, personalized care in order to relieve symptoms related to heart rhythm abnormalities, and improve the quality and longevity of life.

To learn more about Dr. Tordini’s personalized approach to heart care, request an appointment here. You can visit Dr. Tordini’s website here.

Disclaimer: This post is not a substitute for medical advice, diagnosis, or treatment from a licensed medical professional.