What Causes Heart Palpitations & When Should They Be Evaluated?

If you’re experiencing heart palpitations, you’re not alone. Palpitations are very common—in fact, researchers have found that palpitations account for about 16% of the symptoms prompting patients to visit their primary care provider—and in many cases, they’re harmless and don’t require any professional treatment. But in some instances, heart palpitations need to be evaluated and treated by a cardiologist. Below, we discuss what heart palpitations are, what causes them, when they need to be evaluated and how they’re diagnosed and treated.

What Are Heart Palpitations?

A heart palpitation occurs when your heartbeat suddenly becomes more noticeable. It may feel like your heart is:

  • Beating too fast
  • Flip-flopping
  • Fluttering
  • Pounding
  • Producing an extra beat
  • Racing
  • Skipping a beat

Although heart palpitations are often felt in the chest itself, you may also feel them in your neck or throat. They generally persist for only a few seconds or minutes, but in certain cases may last longer. Some heart palpitations occur during activity, while others happen while at rest.

What Causes Heart Palpitations?

Heart palpitations have numerous potential causes, including:

  • Alcohol consumption
  • Anemia
  • Anxiety
  • Blood loss
  • Dehydration
  • Depression
  • Exercise
  • A fever
  • Hormonal changes (for example, those experienced during menstruation, pregnancy and menopause)
  • An irregular heartbeat (arrhythmia)
  • Low levels of carbon dioxide, oxygen, potassium or sugar
  • A panic attack
  • Stimulant use (for example, amphetamines, caffeine, cocaine, nicotine or pseudoephedrine)
  • Stress
  • A thyroid hormone imbalance

When Do Heart Palpitations Need to Be Evaluated?

Your heart is one of the most important organs in your body, so if you’ve experienced a palpitation, you might be worried about what it means. Fortunately, heart palpitations are usually harmless and don’t require any treatment. If you experience heart palpitations infrequently and they last only a few seconds each time, then you probably don’t need to consult with a professional (although you should still mention the palpitations to your primary care provider at your next checkup).

With that being said, some heart palpitations can signal a more serious problem requiring medical attention (for example, an irregular heart rhythm or another heart condition). You should promptly reach out to a cardiologist if you’re experiencing heart palpitations and any of the following is true:

  • You have a history of heart disease.
  • Your palpitations are occurring frequently.
  • Your palpitations have worsened over time.

And if your heart palpitations are accompanied by chest pain or discomfort, shortness of breath, dizziness or fainting, you should call 911 or get to a nearby hospital as quickly as possible.

How Are Heart Palpitations Diagnosed?

When you visit a cardiologist about heart palpitations, they’ll likely begin the appointment by asking you about your symptoms—for example, when your palpitations began, what they feel like and how frequently they occur—as well as your personal and family medical histories. They’ll then perform a physical examination, with the goal of determining what is causing your heart palpitations.

If your cardiologist suspects that you’re experiencing palpitations due to an underlying heart condition, they’ll likely order one or more of the following diagnostic tests:

  • Electrocardiogram (EKG) – A technician will place patches (electrodes) onto your chest, arms and/or legs to measure your heart’s electrical activity.
  • Holter monitoring – If you don’t experience any heart palpitations during a standard EKG, your cardiologist may direct you to wear a portable EKG device that measures your heart’s electrical activity throughout the day.
  • Event recording – If you also don’t experience any heart palpitations while wearing a Holter monitor, your cardiologist might ask you to wear an event recorder and press a button on that device whenever palpitations do occur. Event recorders are most commonly used with patients who infrequently experience heart palpitations (i.e., less than once per week).
  • Echocardiogram – A technician will use a wand (transducer) to produce sound waves and record how they bounce off your heart, creating moving images that will be displayed on a monitor.

How Are Heart Palpitations Treated?

If your cardiologist determines that you don’t have any underlying heart conditions, treatment will likely be limited to avoiding the triggers that are causing you to experience palpitations. For example, if your heart palpitations typically occur when you’re feeling stressed, your doctor might recommend incorporating yoga or meditation into your daily routine. Or, if caffeine or another stimulant is the root cause of your palpitations, your cardiologist will probably direct you to reduce your intake (if you take prescribed stimulants—such as the amphetamines commonly used to treat ADHD—your doctor may recommend an alternative that’s less likely to cause heart palpitations).

But in the event that your cardiologist determines you do have an underlying heart condition, they’ll most likely concentrate on treating that condition, which should in turn reduce any resulting palpitations. For example, if you’re experiencing palpitations due to an irregular heartbeat, your doctor may recommend pacemaker implantation. A heart pacemaker (also referred to as a “cardiac pacemaker”) uses electrical signals to regulate a heart’s rhythm—when a person’s heart slows down too much or misses a beat entirely, their pacemaker sends out an electrical impulse that stimulates their heart to return to its normal rhythm.

Your Choice for Heart Palpitation Treatment in Tampa Bay

If you think you may need treatment for heart palpitations, you can confidently entrust your care to the cardiology team at Florida Medical Clinic. We treat patients at numerous offices across the Tampa Bay area—including ones in Watergrass (at 7760 Curley Road), North Tampa (at 14320 Bruce B. Downs Boulevard) and Wiregrass (at 2352 Bruce B. Downs Boulevard)—and our providers have extensive experience using heart pacemakers to address palpitations and other conditions. Click here to request an appointment with Dr. Gerczuk at one of these locations.

About Dr. Paul Z. Gerczuk, MD

After graduating from St. George’s University School of Medicine, Dr. Gerczuk went on to complete an internal medicine residency at University of Southern California Keck School of Medicine. He also completed fellowships at The Heart Institute at Good Samaritan Hospital (cardiovascular research), Allegheny General Hospital (general cardiology) and University of South Florida (cardiac electrophysiology), and now specializes in abnormal heart rhythms and the heart’s electrical system.



About this author.


Paul Z. Gerczuk, MD

Clinical Cardiac Electrophysiology

  • Accepting new patients

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