Palpitations

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Introduction

What are palpitations?

Palpitations are the sensation that your heartbeat is not normal. Although the sensations may vary, all of them cause you to have an uncomfortable awareness of your heartbeat. Palpitations may be felt in your chest, throat or neck. You may feel as if your heart is racing and pounding, or you may feel as if your heart is skipping beats, fluttering, or stopping.

Palpitations may be felt with a normal heartbeat or may result from an abnormal heartbeat. Palpitations may be mild to severe in intensity and occur only at certain times of day or when you perform certain activities. Palpitations may be recent in origin (acute) or develop over time (chronic). In some situations, palpitations can occur as a result of chronic medical conditions you may have.

There are many causes of palpitations, which range from mild to serious. Palpitations can result from cardiovascular, gastrointestinal, psychological, or respiratory diseases, disorders, and conditions. Cardiac arrhythmias are one cause of palpitations in which the heart beats irregularly or too fast. Certain medications or other substances, such as caffeine, are also known to cause palpitations.

Most palpitations are not serious. However, palpitations may occur as a symptom of a serious or life-threatening condition, such as a heart attack. Seek immediate medical care (call 911) if you experience shortness of breath or pain or pressure in the chest area, or if you think you may be having a heart attack.

Seek prompt medical care if your palpitations are persistent or cause you concern.

Symptoms

What other symptoms might occur with palpitations?

Palpitations may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the heart may also involve other body systems. Some symptoms that may accompany palpitations may indicate a serious or life-threatening condition.

Common symptoms that may occur along with palpitations

Palpitations may accompany symptoms related to other body systems including:   

  • Anxiety
  • Coughing up clear, yellow, light brown, or green mucus
  • Fever
  • Indigestion
  • Nausea with or without vomiting
  • Rapid heart rate (tachycardia)
  • Thirst

Serious symptoms that might indicate a life-threatening condition

In some cases, palpitations may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have palpitations accompanied by any of these life-threatening symptoms including:

Causes

What causes palpitations?

There are many causes of palpitations, which range from mild to serious. Your health care provider will most likely perform diagnostic tests to determine the underlying cause of your palpitations.

Cardiovascular causes of palpitations

Palpitations may be caused by a cardiovascular disorder or disease including:

Gastrointestinal causes of palpitations

Palpitations may be caused by gastrointestinal disorders including:

Psychological causes of palpitations

Palpitations may be caused by cardiac arrhythmias, in which the heart beats irregularly or too fast. Types of cardiac arrhythmias causing palpitations include:

  • Anxiety and anxiety disorders
  • Memory of a traumatic event
  • Panic attack or panic disorders
  • Stress

Respiratory causes of palpitations

Palpitations may be caused by respiratory disorders including:

Substance causes of palpitations

Palpitations may be caused by a variety of medications and substances including:

  • Alcohol
  • Amphetamines
  • Coffee or any product containing caffeine
  • Cold medications containing decongestants, such as ephedrine and pseudoephedrine
  • Diet drugs
  • Medications used to treat asthma, heart problems, high blood pressure, or thyroid disease
  • Nicotine   
  • Stimulants
  • Street drugs such as cocaine, ecstasy, LSD, marijuana and methamphetamine

Other causes of palpitations

Other causes of palpitations include:

Serious or life-threatening causes of palpitations

In some cases, palpitations may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Angina
  • Aortic dissection (bleeding into the wall of the body’s main artery, the aorta)
  • Heart failure
  • Myocardial infarction (heart attack)
  • Pericarditis (inflammation of the sac surrounding the heart)   

Questions for diagnosing the cause of palpitations

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your palpitations including:

  • How long have you been experiencing palpitations?
  • Do you feel a regular or irregular pattern to your heartbeat?
  • Do you feel that your heartbeat is stopping or skipping?
  • Do the palpitations begin or end suddenly?
  • When do the palpitations occur? Do they coincide with any specific activities?
  • Do you have any other symptoms?
  • What medications are you taking?

What are the potential complications of palpitations?

Because palpitations can be caused by serious diseases, failure to seek treatment can result in serious or life-threatening complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment for palpitations
  • Cardiac arrest
  • Coma
  • Difficulty breathing
  • Heart failure
  • Hypoxia (low levels of oxygen in the blood)
  • Respiratory failure and respiratory arrest
  • Stroke
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 21
  1. Heart palpitations. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm
  2. Explore Arrhythmia. National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/arr/arr_whatis.html
  3. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
  4. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
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