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Am Fam Physician. 2005;71(4):755-756

What are heart palpitations?

Heartbeats that are hard and fast are called palpitations (say pal-pit-ay-shuns). Your heart is like a pump. Each time it beats, it pumps blood through your body. When you exercise, it is normal to hear or feel your heart “pounding” as it beats faster. But if you have palpitations, you might feel your heart beating fast while you are sitting still or moving slowly.

What causes heart palpitations?

Many things can cause palpitations. Some of these things have to do with your heart and some of them do not. However, doctors sometimes cannot find the cause of palpitations. This happens in about one of every seven people with palpitations. The palpitations in these people usually are not harmful.

Heart-related causes. People with an irregular heartbeat or arrhythmia also may have palpitations. Most of the time, palpitations and irregular heartbeats are harmless. Sometimes, the break in your heart’s rhythm can be a serious problem. You also may have palpitations if you have problems with the valves in your heart. Valves are what help move blood through the heart.

Non–heart-related causes. Certain medicines, herbal supplements, and illegal street drugs can make your heart beat faster. Medicines that can cause palpitations include asthma inhalers and decongestants. Caffeine (found in coffee, tea, and soda) and alcohol can cause palpitations. People with panic disorder feel their heart pounding when they are fearful of something or having a panic attack. Some medical conditions such as thyroid disease and anemia also can cause palpitations.

How will my doctor find out what is causing my palpitations?

Your doctor will examine you and ask you about any medicines you are taking, your diet, and if you have panic attacks. Your doctor may want you to have a resting electrocardiogram test. This test keeps track of your heartbeat over a certain amount of time. Your doctor also may test your blood.

If these tests do not show what is causing your palpitations, your doctor may have you wear a heart monitor for one to 14 days. This monitor will show any breaks in your heart’s rhythm that may cause palpitations. Your doctor might refer you to a cardiologist (a heart doctor) for more tests or treatment.

What can I do to help prevent palpitations?

  • Do not use illegal street drugs.

  • Avoid caffeine and alcohol.

  • Tell your doctor what medicines and herbal supplements you take, how much alcohol you drink, and if you use anything else that might cause palpitations.

  • Keep track of your palpitations. Write down the time that they happen and what you were doing when they began. Give this information to your doctor.

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