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Heart palpitations are a type of irregular heartbeat (arrhythmia) in which there is a change in the heart’s sequence of electrical impulses.
Most of the time the heart palpitations are not a cause for concern and they only cause minor symptoms such as feeling:
- As if you skipped a heartbeat
- The heart is beating faster than normal
- As if the heart is pounding in your chest
- Fluttering in the chest or neck
However, there are some types of arrhythmias that can be signs of medical conditions:
- Tachycardia
- Heart rate is too fast (in adults, more than 100 beats per minute)
- Bradycardia
- Heart rate is too slow (in adults, less than 60 beats per minute)
- Atrial fibrillation (AFib)
- Upper heart chambers contract irregularly
- Ventricular fibrillation (VFib)
- Disorganized contraction of the lower chambers of the heart
- Conduction disorders
- Heart does not beat normally
- Premature contraction (PACs and PVCs)
- Early heart beat
See a doctor right away if you have palpitations and:
- Chest pain or pressure
- Difficulty breathing/ shortness of breath
- Lightheadedness/fainting near-fainting spells
- Dizziness
- Excessive sweating
- Swelling in your leg
- Fatigue
- Weakness
- Confusion
- Anxiety
- Symptoms persist or frequently return
- You have certain underlying medical conditions such as:
- Coronary artery disease
- Congestive heart failure
- Cardiomyopathy
- Family history of heart disease
- Abnormal heart valve
- Heart attack
- High blood pressure
- Diabetes
- In severe cases, collapse and sudden cardiac arrest
- Cardiac arrest is a serious medical emergency and can be fatal.
- If someone you know is experiencing any symptoms listed below call 911 and get to a hospital’s emergency department immediately.
- Sudden loss of responsiveness
- No normal breathing (not breathing at all or gasping for air)
What Causes Heart Palpitations?
Heart palpitations may be caused by:
- Too much caffeine
- Fever
- Certain emotions
- Anxiety
- Stress
- Panic
- Fear
- Nicotine from cigarettes or e-cigarettes
- Electrolyte abnormalities
- Increased exercise
- Diet pills
- Illegal drugs, such as cocaine
Other types of arrhythmias may be caused by:
- Heart attack
- Heart changes with age
- Congenital abnormality of the heart’s electrical system
- Inherited heart disease
How Are Heart Palpitations Diagnosed?
Tests to diagnose the cause of heart palpitations include:
- Electrocardiogram (“ECG”)
- Echocardiogram (“echo”)
- Stress test (treadmill test)
- Electrophysiology test (EP study)
- Esophageal electrophysiologic procedure
- Tilt table test
- Diagnostic monitors
- Holter monitor
- Transtelephonic monitor
- Cardiac catheterization (“cardiac cath”)
- Magnetic resonance imaging (MRI) scan of the heart
- Computed tomography (CT) scan of the heart
- Blood tests: brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) or cardiac enzymes such as Troponin
What Is the Treatment for Heart Palpitations?
In many cases, no treatment is needed for heart palpitations and they go away on their own.
When treatment is needed for certain arrhythmias, it may include:
- Medications
- Antiarrhythmics
- Class I (fast sodium channel blockers)
- Class II (beta-blockers)
- Class III (potassium channel-blockers)
- Class IV (calcium channel blockers)
- Class V (other)
- Anticoagulants (blood thinners) such as warfarin
- Antiarrhythmics
- Ablation
- Cardioversion
- Implantable devices
- Implantable cardioverter defibrillator (ICD)
- Pacemakers
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https://www.heart.org/en/health-topics/arrhythmia
https://www.amboss.com/us/knowledge/Antiarrhythmic_drugs
https://wexnermedical.osu.edu/blog/when-get-irregular-heartbeat-checked
https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2019/december/heart-palpitations