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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  • 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.

  • henry

    I use to smoke alot of weed but quited last year because of a really bad panic attack that i had from it. After that ive been having palpitations. I went to the ER they said my palpitations were hard but nothing out of the normal. So i went to go see a general doc he did a blood test and said everything was ok with my heart, but i atill get them almost every day. Even when i go and watch a movie i get them. Idk whats going on. You got any idea of what causes them?

  • Haley

    I just got back on amphetamine, i accidentally overdosed my amount by taking it at night then again in the morning. I was on 40mgs. The next day my heart was pounding in my chest and i was really jittery and nervous and scared. I also have really bad anxiety and once i felt a huge THUMP in my chest, i was panicked! My left side of my thyroid is tightened up from my anxiety and i’m really scared i caused permanent damage to my heart. Should i be worried or is it just because my body isn’t used to being on adderal anyore

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

      Haley, I hope you’re being treated by a doctor you can trust. Because, I guess you know, you need a very good reason for being on amphetamines because of the side effects, including anxiety. If you have questions about your heart, you should talk to your doctor and see if you need an exam.

  • jep

    I started cymbalta one week ago and stopped today because of all the palpitations I was having. Having them nonstop today. Should I be concerned?

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

      You should have them checked out.

  • Samer Saber Yahia

    Thanks for the great article Doc, palpitations are so annoying for me however they come with no dizziness, heavy breathing or pain whatsoever .. but I’ve been experiencing them for hours now .. I drink like 1 cup of coffee a day and like 2 or 3 teas .. I do exercise occasionally .. had a couple of visits to the doctor he listened to my chest and told me there is nothing wrong with your heart, and it’s funny that one of those times he got me my money back and told me don’t pay much attention to it.
    Should I really do that Doc? or should I go for a thorough check?

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

      Samer, that’s up to up. Sounds like you should have a thorough checkup.

  • Nina

    I have been experiencing heart palpitations for 2days now and my heart palpitates 5 times in a minute. Should i see the doctor?

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

      yes.

  • SiberianHusky

    Thanks for the simple yet detailed explanation. I started paying attention to heart rate irregularities since I started using a heart rate monitor during exercising. They start when I run fast or perform intensive demanding exercises like pull-ups. However, I felt ok otherwise and I didn’t know what to think – I really thought that the heart is supposed to beat regularly like a metronome, lol. It’s like a revelation to find out that it is not:)

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

      Thanks. Though, If you have doubts or concerns, you should see a doctor for a good checkup and, possibly an exercise test.

  • Giovanni

    I have palpitations from time to time. My mom tells me I am gonna die if I have them frequently which kinda made me nervous. Thank you very much for providing this information,

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

      You’re welcome

  • joeymac

    I have been having palps off and on for the last two days. I do have acid reflux and hypochondria. Blood pressure on the higher end of normal and decent cholesterol. I’m starting to freak a little.

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

      If you’re worried, have it checked out.

  • Riley

    I’ve been having heart palpitations all my life. Luckily, I’m not dead. At first, they were scary as hell but now… It’s just… Meh. Harmless. Unless you’re getting woken up by them, it’s hardly a problem.