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, 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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  • WR

    Can the hormonal changes of menopause cause heart palps too? Once in a while I get palpitations but it’s sporadic at best. No fast pulse or anything alarming, just a flip/flop once in a while. I don’t do caffeine or anything else that might cause it. My care provider was not alarmed but did not do an EKG. I read somewhere that many women experience heart palps as part of the menopausal transition, but it’s often dismissed as a panic attack and nothing more. What do you think – can heart palps be part of perimenopause?

    • James Hubbard, MD, MPH

      Yes, heart palpitations can be caused from hormone changes but if you have concerns ask your doctor about doing some heart tests or referring you for some.

  • Barbara Chira

    Hi, Dr. Hubbard. I am a 57 year old female, overweight (secondary to early knee arthritis), and have been having palpitations (“flops,” feeling pulse in neck, etc.) for 2+ weeks. It does not seem to recede very much – fairly constant. Resting heart rate has been between 64-82. The extra beats seem to be between 0-6 times per minute; when they happen, I feel a little lightheaded, but it passes within seconds. They seemed to me to begin leading up to a series of dental appointments, the last appointment of which was on Friday. Now this weekend, being home from work, snowed in, and not busy, I have grown more concerned, and wondered if I should go to the ER. I drink 1 cup of coffee per day, no alcohol, and do not smoke. I cut out coffee on Friday. The only daily medication I take is Meloxicam for knees, and Prilosec.

    I had palpitations once before, about 6 years ago; the family doc said they were likely related to what was the recent death of my mom at that time. He did not do an EKG or order any tests. Theu were not at all as troubling as they are now, and they resolved in a few weeks.

    Thank you for any feedback.


    • Barbara Chira

      Also, I have been reading that there is a connection to the vagus nerve, and wondered what you thought of that.

      • James Hubbard, MD, MPH

        Barbara, sounds like you should have the palpitations checked out. Maybe talk to your regular doctor or go to an urgent care, or the emergency room if you deem that best. I’m not sure what you’re asking about the vagus nerve. Yes, it affects the heart, but I’m not sure how it relates to your symptoms. Here’s a post on how how it can slow the heart in certain circumstances but, again, your described symptoms don’t fall into that category.

        • Barbara Chira

          Hi, Dr. Hubbard – I had an appointment with my internal medicine doc this morning. 10-second EKG normal, or at least, no change from previous, 7-8 years ago, when I was age 48-49. Tomorrow I get set up with a 24-hour Holter monitor, and Thursday I have a chemical (non-exercise, due to knee arthritis) stress test. It was a big relief to hear that my EKG had absolutely no changes from 7-8 years ago, a time prior to disabling knee arthritisi, when I was still fit, physically active, and feeling healthy.

          • James Hubbard, MD, MPH

            Great news. I wish you the best.

          • Barbara Chira

            Thank you for your support, information and encouragement. I had never heard of a chemical stress test, and am a little fearful about having it. Would rather have an exercise test, and could manage a stationary bike, but I don’t think they have that equipment. Well, at least the chemical part of the test should be over in < 10 minites, I imagine. Thanks, again.

  • Christian

    I’m 18 and in great shape, but a few years ago I felt a palpitation and since then I’ve been completely conscious of my heart beat, I’ve always been extremely athletic and in shape, but now I have severe anxiety and panic attacks to the point I can literally do nothing. Most of the time I have one to three palps at a time, but sometimes I have more. One time 20 in a row, and today in about 8 waves of 5. I have had an ekg, a stress test, and two echocardiograms that all came back normal. I drink no caffeine . Could the doctors have missed something?

  • denroy

    HI, i am 18 years old and last summer i had a panic attack and continued having them for several months and now after my first go aorund with palps they have gone away but recently while walking im not sure if it my lungs or heart but i find myself gasping quickly then that puts me on edge it used to happen at home but now it happens mostly when i am walking does this seem like something serious? Ive been to the doc alot and did alot of tests and evrything came back fine but i dont feel fine maybe its anxiety but its just scary to deal with because this is all new to me

  • Justin

    When I was 25 years old (I’m 30 now) I would get palpitations every once in awhile, so I went to a cardiologist, and he said the EKG was showing that I had an extra heart beat every once and awhile and to just cut back on caffeine and I should be fine. That seemed to fix the problem until this past year or so. Several times in the middle of working out, my heart starts to flutter violently for about 20-30 seconds. It scares me so bad, I just have to stop what I’m doing and try and walk it off. I plan on going to see my primary as soon as possible, but was wondering if you could offer me any advise. Thank you for your time.

    • James Hubbard, MD, MPH

      Justin, yes, see your primary care doctor this week. Also think are there any new triggers such as increased anxiety, change in diet, any meds, herbs, supplements, smoking, caffeine.

      • Justin

        Will do, thank you.

  • 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?

    • 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.

    • 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.

        • 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?

    • 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.

  • 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.

    • 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,

    • 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.