By: Kathy Hubbard
You experience a sensation that your heart is pounding or racing. You might describe it as flip-flopping, fluttering or skipping a beat. It happens once in awhile and doesn’t last very long. Is it something to worry about? Probably not. But maybe.
The Cleveland Clinic says that most people get palpitations because of anxiety. “Other causes include pregnancy, caffeine, alcohol or spicy food. Heart palpitations are common and usually aren’t dangerous.”
However, even though they’re mostly not serious, they shouldn’t be ignored. And please note, if palpitations are accompanied by chest discomfort, shortness of breath, nausea or other heart attack symptoms, call 911 immediately.
The American Heart Association tells a story on their website about a ballet dancer who could feel his heart beating extremely fast during rehearsals when he was only sixteen years old. He ignored them. At nineteen he joined the Joffrey Ballet and during performances experienced his heart racing and felt particularly tired. His doctors found nothing wrong with him.
The palpitations continued. Doctors still found no underlying problems. That is, until they did. When he was 26 his symptoms occurred more often and lasted longer. After a stress test, an electrocardiogram was performed and the attending doctor sent him directly to the emergency room.
“The doctor told him he had AFib, or atrial fibrillation, which is an irregular heartbeat. If left untreated, it can lead to blood clots, stroke, heart failure and other heart-related complications,” AHA explained.
Anyone can have heart palpitations, but they’re more common in females. And as for how common they are, they’re the number one reason people visit a cardiologist. Cleveland Clinic talks about one study that showed that sixteen percent of the population had seen their primary care provider because they had palpitations.
The list of possible causes for palpitations is long. Besides those mentioned above, palpitations can be caused by an overactive thyroid; low levels of sugar, potassium or oxygen; low carbon dioxide in the blood; fever; anemia; dehydration; blood loss; medications such as asthma inhalers, beta-blockers, thyroid drugs, and antiarrhythmic medicines; some cough and cold medicines, including decongestants; some herbal and nutritional supplements; recreational drugs and nicotine.
“There are a number of diagnoses that may fall into that broad term of ‘heart palpitations,’” said Dr. Larry R. Jackson II, an associate professor of medicine at Duke Health in Durham, North Carolina. As a cardiac electrophysiologist, he studies heart rhythm disorders. I found his article on the AHA website.
“Sometimes the sensation of a skipped beat might be a premature contraction, where either the upper or lower chambers of the heart beat early. Many times, people are having absolutely normal heart rhythm when they’re complaining about heart palpitations. That doesn’t mean the palpitations aren’t real, but electrically, it’s just not emanating or coming from the heart. So, it can be really difficult to explain sometimes.”
What should you do if you experience palpitations? Dr. Jackson said, “If palpitations bring new symptoms, such as lightheadedness, dizziness, shortness of breath, chest pain or the feeling you’re about to pass out or actually pass out – that’s a big problem. One that requires medical attention sooner rather than later.”
That doesn’t mean it’s going to be anything life-threatening, Jackson said. “But any change from baseline should really precipitate an evaluation.”
Cleveland says it’s helpful to let your healthcare provider know the details of your palpitations. It should start with keeping track of when and how often they happen; how long they last; how you feel when they happen; what you were doing when they start; what helps you feel better.
Your provider may order blood tests, urinalysis, electrocardiogram, stress test, or echocardiogram. You may be asked to wear a Holter monitor for a day or longer to record your heart’s activity. The medico may want an electrophysiology study (a detailed analysis of the electrical activity in the heart) or cardiac catheterization (invasive imaging procedure involving a tube inserted to look at the heart’s structure).
Often palpitations just go away without any treatment. If you know your triggers, you can control them. Employ calming activities, avoid or reduce caffeine, control your blood pressure and cholesterol levels. And, of course, if you use tobacco or nicotine products, stop.
Kathy Hubbard was a charter member of Bonner General Health Foundation. She can be reached at [email protected]. This article was written for publication in the Bonner County Daily Bee on February 19, 2025.