The term palpitations describes an unusual awareness of the heartbeat.
Ordinarily, a person is not aware of the beating of his or her heart. Under certain circumstances, such as when scared or under stress, a person may become aware of the heartbeat. This awareness of the heartbeat is known as palpitations. Often, the heart may seem to beat faster or harder than usual. In some cases, palpitations may occur due to an irregular heartbeat, also called an arrhythmia.
Palpitations happen to almost everyone at some time in their life. Usually they're nothing to worry about. In some people, the perception of having palpitations is caused by emotion or stress rather than an actual extra beat. However, palpitations may signal a serious condition, especially if they are caused by an arrhythmia.
Common causes of palpitations include:
Risk of palpitations range from no risk to death. The determining factor is the nature of the palpitations, how long the runs are, and the location of the palpitations in the heart.
Symptoms of palpitations have been described as a flopping sensation in the chest and throat. It is rarely painful but usually associated with anxiety. Palpitations can be associated with the sensation of a rapid heart rate.
Diagnosis of the cause of palpitations starts with a history and physical exam. Many times the palpitations have stopped by the time the person seeks medical attention. But the healthcare provider will want to know the answers to these questions:
The healthcare provider may conduct any of these tests to check the palpitations:
Prevention is related to the cause. For example, if palpitations are caused by anxiety, the use of an anti-anxiety medication may prevent this condition. Avoiding the precipitating factors such as certain medications, coffee, tea, or alcohol can prevent palpitations. Many causes cannot be prevented.
Sometimes palpitations may be a warning sign of underlying heart disease. If palpitations are caused by a problem with the heart, death can occur if the condition is not diagnosed and treated. In children, palpitations are usually more of a nuisance than a medical problem.
There are no risks to others.
The treatment depends on what's causing the condition:
Side effects depend on the treatment used. Heart medications used to quiet the palpitations can cause worsening of the palpitations, life-threatening arrhythmias, swelling, severe allergic reactions, fatigue, dizziness, headache, and depression.
Simple, intermittent palpitations require no treatment and have no long-term consequences. If the palpitations continue, then long-term follow-up is required. If the underlying disease is curable and the palpitations go away, no further treatment may be needed.
The person monitors the frequency of palpitations. Any irregularity lasting longer than a few minutes should be evaluated immediately by a healthcare provider. Medical help should be sought immediately if the person has chest pain, shortness of breath, excessive sweating, dizziness, or fainting. Regular visits to the healthcare provider to adjust heart medications may be required. Changes in the pattern, intensity, or duration of palpitations should be reported to the healthcare provider right away.
Author:Gail Hendrickson, RN, BS
Editor:Wendel, Sandra J., BA
Reviewer:Eric Berlin, MD
The Merck Manual of Medical Information, Home edition, 1997
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000
Harrison's Principles of Internal Medicine, 1998, Fauci et al.