Heart Palpitations: The Many Causes of Those Flutters and Flip-Flops

It’s not unusual to occasionally have a fluttering sensation in your chest or feel like your heart skipped a beat. Heart palpitations are common, and the good news is they are usually harmless. However, in rare cases, they can be a symptom of a serious problem. But how do you know the difference?

“Heart palpitations can be premature or extra heartbeats, often triggered by changes in your diet, exercise, sleep or stress,” says Dr. Stuart Smalheiser, a board-certified cardiologist at Beaufort Memorial Heart Specialists. “Sometimes, though, they could be a sign of a heart rhythm problem or another serious heart condition, so it’s a good idea to see your primary care provider if you have other symptoms along with palpitations.”

What Do Heart Palpitations Feel Like?

Palpitations can feel like missed or extra heartbeats or rapid fluttering or flip-flopping in the chest. For some people, heart palpitations can feel like a pounding sensation in the neck or chest or an unusual awareness of their heartbeat.

The variation in sensation stems from what causes your heart palpitation. Heart palpitations often result from ectopic heartbeats, which are early or out-of-sync beats. There are two types of ectopic heartbeats:

• Premature atrial contractions (PACs): The heart’s atria, or upper chambers, contract slightly earlier than they should, leading to the ventricles, or lower chambers, contracting more strongly. You may feel like your heart skipped a beat.
• Premature ventricular contractions (PVCs): The ventricles contract earlier than usual, creating a pounding or flip-flopping feeling.

Read More: Maintain a Healthy Heart Rate With These Tips

Uncovering the Causes

Heart palpitations occur for many reasons, not all of which are cause for concern. You can experience heart palpitations due to lifestyle factors, such as:

• Drinking too much caffeine
• Exercising
• Smoking and using nicotine products
• Stress, anxiety and panic attacks
• Taking certain medications, such as decongestants or medicines for asthma and high blood pressure

You can also develop heart palpitations for medical reasons, including:

• Abnormal level of potassium in the blood
• An iron deficiency
• Hyperthyroidism (overactive thyroid)
• Low blood oxygen levels

Are Heart Palpitations a Sign of Heart Disease?

In some cases, heart palpitations could be a warning sign of heart disease or an arrythmia, an irregular heartbeat related to a heart rhythm problem. Supraventricular tachycardia (SVT) is a type of arrythmia that can boost your heart rate much higher than normal. While a normal heart rate is 60 to 100 beats per minute, SVT can raise your heart rate to 250 beats per minute.

Atrial flutter, a rapid but regular heartbeat that can signal underlying problems, and atrial fibrillation, a serious irregular heartbeat that raises stroke risk, are two types of SVTs that require medical attention. Abnormal heart valves and other serious heart problems can also cause palpitations.

When to See a Doctor

Although heart palpitations aren’t always serious, discuss them with your primary care provider so they can help determine what’s causing them. Your provider can also review your health history to see if you have risk factors for heart disease, including high blood pressure, high cholesterol and diabetes.

You want to see a doctor as soon as possible if you experience heart palpitations along with any of the following symptoms:

• Chest pain
• Feeling faint, dizzy or lightheaded
• Shortness of breath
• A pulse of more than 100 beats per minute
• Frequent extra heartbeats (six or more per minute or heartbeats that come in groups of three or more)

Your provider may order an electrocardiogram, a quick, painless test that records your heart’s electrical activity. They may also have you wear a Holter monitor or other type of heart monitor that continuously records your heart rhythms so they can determine whether your palpitations are related to an arrhythmia.

Read More: Heart Rate vs. Blood Pressure: What’s the Difference?

Restoring Your Rhythm

Based on the results of your visit and any follow-up tests, your doctor may recommend:

• Lifestyle changes — Limiting caffeine, practicing relaxation techniques, managing stress, ensuring you get enough sleep, and quitting smoking can help.
• Medication adjustments — If a medication you’re currently taking is found to cause palpitations, your provider might adjust your dosage or switch you to a different medication. Or, your provider may prescribe a new medication to treat an underlying cause. Beta blockers, for example, are commonly used to reduce heart rate and treat palpitations associated with arrhythmias.

Your heart is your body’s hardest-working organ, and you want to protect it as best you can. Even if your palpitations are related to too much coffee or a stressful situation, your provider can help you find the treatment necessary to keep it beating regularly and in sync as long as possible.

Concerned about heart palpitations? Schedule an appointment with a member of our heart care team in Beaufort or Okatie.