Are Heart Palpitations Dangerous? A Doctor Explains

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Are Heart Palpitations Dangerous? A Doctor Explains

Are heart palpitations dangerous? A doctor explains what happens when your heart seems to skip a beat.

[Editor's note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It's now featured here as part of our new general-health section.]

rabbit-heart-palpitationsby Eva F. Briggs, M.D.

Q. What are heart palpitations? Should I be concerned about them? Also: I don’t understand how my heart can skip a beat and it doesn’t cause any damage! Why doesn’t it?

A. On television and in the movies, the human heartbeat is portrayed as steady as a metronome: lub-dub, lub-dub, lub-dub. But our hearts aren’t mechanical, and sometimes Mother Nature skips a beat, or sneaks one in early. When that happens, you feel the irregularity as a peculiar thump or fluttering sensation: a palpitation.

What Causes Heart Palpitations?

Most palpitations are not dangerous. They’re due to minor system glitches.

Your heart has a built-in pacemaker. Sometimes the atria (upper heart chambers) or ventricles (lower heart chambers) jump in before the pacemaker fires. The result is an early beat, called a premature contraction. The heart often responds by delaying the next scheduled beat.

People may not even notice the early beat, but perceive the interval until the second, delayed beat as a skipped beat. The body is actually maintaining the overall balance and continues to function without any harmful effects on circulation.

One common reason for these premature contractions is epinephrine. Sometimes called the fight-or-flight hormone, epinephrine can increase your heart rate, often causing rapid or early beats felt as palpitations. Your body makes more epinephrine when you’re frightened or stressed. That explains why your heart seems to thump right out of your chest during a scary movie.

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When Are Heart Palpitations Dangerous?

Sometimes palpitations do indicate a heart problem. Warning signs for underlying serious problems include:

  • Continuous palpitations—over six per minute or three in a row.
  • Lightheadedness
  • Shortness of breath
  • Passing out
  • Chest pain

Potential serious causes of heart palpitations include:

  • An overactive thyroid
  • Blockage in the coronary arteries
  • Electrolyte imbalances (sodium, potassium)
  • Diseases of the heart muscle
  • Abnormalities in the heart’s electrical system
  • Malfunction of the natural pacemaker

(The last two can lead to the heart not beating efficiently, potentially weakening it.)

What Are the Tests for Heart Palpitations?

To help find the cause of palpitations, your doctor will likely perform an electrocardiogram (EKG). This simple test records the heart’s electrical activity through electrodes attached to the chest. The tracing provides information not only about the heart’s rhythm, but also about its size, evidence of prior structural damage and possible delays in the electrical signals.

Often, the troublesome palpitations don’t happen while you’re at the doctor’s office. In that case, your doctor may hook you up to a portable monitoring device that records the heart rhythm as you go about your daily routine. Depending on the doctor’s initial findings, he or she may order additional tests such as blood work or an echocardiogram (sound wave picture of the heart).

What Is the Treatment for Heart Palpitations?

If nothing serious is causing the palpitations, the first treatment step is generally lifestyle modification, such as cutting back on caffeine and avoiding decongestants. (These stimulants can exacerbate palpitations.) Also, regular aerobic exercise leads to a slower baseline heart rate that’s less susceptible to palpitations.

Prescription medicines are reserved for the most stubborn cases. The most commonly used drugs, called beta-blockers, act by slowing the heart rate.

Luckily, most people won’t need medicines to treat palpitations that aren’t due to heart disease or illnesses. Sometimes the reassurance that your heart is normal is enough to make the palpitations less scary and therefore less noticeable. Remember that even though it seems as if your heart is going haywire, it’s still pumping all the blood required by your brain and other vital organs.

But if you have any question at all, see your health-care provider to make sure of the cause.


EVA F. BRIGGS, M.D., is a board-certified family physician in Marcellus, N.Y.

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Original version appeared in May/June 2008 issue of My Family Doctor magazine. This general health-care information is not meant as individual advice. Please see our disclaimer.

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  • Dean

    I’m 21 and I’ve been having palpitations (especially last night where my heart would race from time to time) which caused huge concern because I’ve never had them before. Been to the Doctors today and I was told that (Like what most people have said they’re Doctors told them) it’s nothing to worry about. Try to avoid taking things that speed up the rhythm of your heart such as caffeine. Also I was told that exercise can play a role in it, does this mean I should cut down on the amount of exercise I do?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Great question. I would think regular, exercise would help. If you think they might have said otherwise, I would call the office and get it clarified by the doctor.

      • Dean

        Okay thank you so much for your advice and your efficiency on replying :)

  • Laurie

    I have palpitations from time to time and decided to see a cardiologist since my father passed away last year from a massive heart attack (which was linked to him being exposed to agent orange in Nam). He did an EKG, I wore a heart monitor for 24 hrs. and he ordered a nuclear stress test which all the results came back that my heart is fine. My cholesterol is perfect too. My only problem is that I am over weight. Last night my heart began palpitating from around 9 pm and continued throughout the night. Whenever I woke up (which seemed like every hour) my heart was still pounding like I had just been running. I decided to take an 81mg aspirin and when I awoke around 8 am, my heart was back to normal. I have never had the palpitations last that long ever. I wasn’t sure if I should be concerned or not, even though I worried.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Usually when you wear a heart monitor you press a button when you feel a palpitation. Were you able to do that and were they able to tell you what your heart was doing during that palpitation time? If not, I’d check back with your doctor. Also, even if the beats are not life-threatening there are medicines that might help but the obvious thing that might help the most is a little weight loss and regular exercise.

      • Laurie

        Yes, Dr. Hubbard, I did have that type of heart monitor. Unfortunately on the day that I wore it I hardly had any palpitations. I do take Atenolol for high blood pressure, but even when I was off that for two days prior to the nuclear stress test, my bp wasn’t high (130/80) the morning of the test. I am just really out of shape and it doesn’t take long for me to reach my target heart rate when I walk. I believe during the stress test it took me only 30 seconds on the treadmill. I am about 60lbs. overweight. To begin a walking exercise program, I don’t know how long or how fast I should be walking. The sound/feeling of my heart beating quickly and to be out of breath is scary.

        • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

          There’s nothing wrong with starting out slow. Before starting, I’d check with your doctor for specific advice.

          • Laurie

            Thank you for the feedback Dr. Hubbard.

  • Myrna Ramirez

    Hi I am a little worried because my palpitations are sometimes non-stop and i really don’t like that feeling, how can I make it stop? I do take several medications but then again I tend to forget at times could that be a reason why I feel this way?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Depending on what the medicines are for, missing dosages could definitely cause palpitations. Either way, if you haven’t had them checked out, you should. Here’s another post that might be of interest. http://www.thesurvivaldoctor.com/2012/10/25/fast-heart-rate/

  • bLa07

    25 years old. Graves Disease (hyperthyroidism) causes heart palpitations that cause shortness of breath. Very active while lying down. Makes trying to sleep difficult some nights, but doc says it’s fine. Lucky I’m young.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks for sharing.

      • tommy

        Well I had heart palpitations they told me not to worry about they started treating me for anxiety. Over the course of 5 years I was treated for that. I did the bloodbtests they were all good did the EKG all good nuclear stress tests all good. 2 weeks later I was having open heart surgery…oh and the night I went in to the er my EKG was good blood work and xrays were good they had me convinced I was just crazy but thank God the er Dr called the on call cardiologist and he did a heart cath just to be safe….100% 90% 80% and 70% blockages…yup 4 of them I was a walking time bomb.not trying to scare anyone just saying some of these tests are useless. My heart Dr told me if you are hooked to an EKG machine and have a heart attack there is only a 50/50 chance it will show up. The heart cath is the only really accurate test out there. Make them do one just to make sure. Your life may just depend on it.

  • Sarah

    Hi Dr James,
    I am 30 years old and have been having palpations since I was a teenager. Recently though, they have been getting more frequent, and now I have palpitations every single night. I know most palpitations aren’t serious, but should I be concerned that they have become a daily occurrence? Sometimes I will get 2-3 palpations a minute, other times maybe 6 palpitations over half an hour. Sometimes they are so extreme that they force me to cough as it feels like the air gets sucked out of me. I hardly ever drink alcohol, have never smoked and don’t drink coffee at all.
    Any advice would be much appreciated.
    Thanks doctor,
    Sarah

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sarah, you should see a doctor for a checkup to find out what heart irregularity you have. Some types are dangerous. Others aren’t. If it’s the non-dangerous type, could anxiety and stress be an issue. Regular exercise, like brisk walks, may help the not-dangerous type.

      • Sarah

        Ok, I will do that. Thank you so much for your reply.

  • Lee

    I have just started having them but i experience no pain and they really on come when im working. I went to the er and all my test were fine. I do have a history with heart problems as such as having open heart surgery when i was 10. Now i am 28. Will the ekg tell the doctor exactly what is wrong?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sometimes the ekg can tell you what’s exactly wrong, if it’s done while you’re having the palpitations, otherwise you should follow up with your regular doctor to see if other tests are in order.

  • Jay

    I have had palpitations for 3 weeks now. I’ve had two ekg’s and have worn a holter monitor for 48 hours. Everything shows that I am having PAC’s. They last anywhere from 5 minutes to 30. I feel them one after another. Doc tells me there are benign and not to worry. I don’t use any stimulants. I’m not able to see the cardiologist for another 12 days. I’m 33 years old and have played soccer all my life, never having an issue before. Sometimes after I feel several in a row, my chest will feel sore. How concerned should I be?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Jay, that’s a question best answered by the doc who checked you out. In general, they are usually benign (nothing to worry about), sometimes made worse by stress or caffeine. Very, very rarely there could be an underlying heart problem.

  • grace

    a year ago i was diagnosed with post par tum cadriomypothy,but now when i went for last check up a two months ago ,they told me i have improved very well and that i am now out of danger,but now i get palpitations whenever i didn’t get enough sleep or i am stressed or have been crying,i get really worried and they told me i was healed,what are these palpitations for and should i get worried ??????

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Grace, that’s great news about the cardiomyopathy getting better. You should have the palpitations checked out. I’d ask the same doctor that’s been seeing you for the cardiomyopathy.

  • Rachel

    I have a history of Palpitations ( when I’m stessed, tired, too much caffeine, etc) I went to the ER about 2 years ago with them and saw a cardiologist who performed the EKG, an echo, a treadmill test and a holter monitor. Basically he said its normal to get them sometimes. Now for the past two weeks I’ve been getting them on and off way more frequently. They seem stronger. I feel out of breath and really really tired. Also on and off the center of my chest feels really tight and sore ( like a sore muscle whe you work out too hard) . I feel stupid going in to the dr when I think it can just be stress. Can stress cause this? Even when I’m not thinking about anything stressful, etc? I don’t have a pcp and I hated the cardiologists staff, they made me really uncomfortable. I don’t know what do do.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Find a pcp, go to an urgent care, or find another cardiology group. Certainly stress can cause all your symptoms. Hopefully you’ve cut back not the caffeine and tried to get more rest. But, since your symptoms have changed, you should be rechecked.

      • Rachel

        Wow, thank you so much for such a quick response. Yes I cut back on caffeine. I used to have 2 cups off coffee a day and now only one in the am ( I don’t think i would function without it) and I get between 6 and 8 hours of sleep a night. I’ll get an appt. thanks.

  • Randy

    I have palpitations sometimes. I usually ignore them because they only last for a few seconds. The times I get worried is when they hurt. I am 20 years old and about a half hour ago I experienced some major palpitations that hurt very much. It lasted for about 15 seconds. I feel fine now, though I am anxious. What is the difference between sever and mild chest pain?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Randy, in general, with mild pain you can continue your activities, maybe even not noticing the pain that much sometimes. Severe is when it stops you in your tracks. But, just because it’s mild doesn’t mean you shouldn’t get checked out.

      • Randy

        Thank you. Perhaps I will see my doctor.