Listen to Your Heart: 10 Things to Do If It Isn’t Beating Right

When you experience heart palpitations, you have a heightened awareness of your own heartbeat. It may be beating too fast, too slow, or irregularly. You might feel like your heart is racing, thumping, or fluttering. You may feel these sensations in your neck or your chest. 

Heart palpitations are usually harmless, but occasionally, they can be caused by a serious condition such as arrhythmia (irregular heartbeat). 

Some common causes of heart palpitations include: 

• Stress, anxiety, or panic attacks
• Stimulants such as caffeine, tobacco, methamphetamines, cocaine, and medicines containing pseudoephedrine 
• Fever
• Imbalance of thyroid hormone
• Hormonal changes 

Some conditions can make it more likely that you'll have heart palpitations, such as:  

• Panic attacks or anxiety disorders
• Stress
• Pregnancy
• Stimulant medicines like cold or asthma medicines
• Overactive thyroid glands
• A history of heart problems such as structural heart changes, previous heart attacks, previous heart surgery, or irregular heartbeats

If your heart palpitations only last a few seconds and are infrequent, they probably don't need to be evaluated. You should be evaluated, however, if you have a history of heart disease and have palpitations that happen frequently or get worse. 

You should also be evaluated if your heart palpitations coincide with:  

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

Sometimes, heart palpitations are caused by a type of arrhythmia called supraventricular tachycardia. This is a very fast heart rate that occurs above the lower heart chambers. It can cause your heart to beat erratically or rapidly. You may have a fast pulse and feel dizzy. 

Atrial fibrillation is the most common type of arrhythmia. It causes a fast and erratic heartbeat. There may not be any symptoms, or you may notice chest pains, palpitations, or shortness of breath. Atrial fibrillation can interfere with the blood flow to your lower heart chambers and can cause clots or a stroke. 

Ventricular tachycardia is a type of rapid heartbeat that occurs in the lower heart chambers. This arrhythmia can be associated with structural heart disease. When it is, it can sometimes cause a loss of consciousness and, rarely, cardiac arrest or death. 

If palpitations are caused by a heart condition, complications can include: 

• Fainting because of low blood pressure
• Cardiac arrest
• Stroke, if palpitations are caused by atrial fibrillation 
• Heart failure if the arrhythmia reduces the heart's ability to pump 

Your doctor will conduct a physical examination. If they think your palpitations might be caused by a heart condition, you may need further testing. 

Some tests your doctor may conduct include:   

• An electrocardiogram (EKG or ECG) to measure the electrical activity of your heart
• A Holter monitor, which is a portable EKG device that you wear for a day or more
• Event recording, which involves pressing a button when symptoms occur for 30 days or more
•  Echocardiogram, which uses sound waves to create moving images of your heart

You may be able to help treat your palpitations with some lifestyle changes such as:   

• Reducing stress with relaxation techniques, yoga, or deep breathing
• Avoiding stimulants such as caffeine, cold medicines, and nicotine
• Avoiding illegal drugs such as cocaine and methamphetamines