What is Happening to my Body?

The sensation of palpitations may be felt along with other symptoms, for example when you have a hot flash, or just on its own. There are many changes in how the heart is beating that can cause this sensation. Usually, these changes happen for a short period of time and then the heart returns to beating normally.

• The heart may beat harder than normal during a hot flash. This is because as our blood vessels dilate to get rid of heat our blood pressure falls a little. Our heart beats harder to raise our blood pressure. This may be felt as a pounding heartbeat.
• The heart may have short periods where it beats faster or slower than normal.
• The heart may have “early” or “skipped” beats.

Many things can trigger palpitations. Too much stress, caffeine, chocolate, nicotine, and alcohol can all cause palpitations. Illegal drugs including cocaine and amphetamines can also cause them. There are some prescription drugs and over-the-counter drugs (for example cough and cold medicines) that may increase them. They may happen during panic attacks, or if you have a fever.

What to Expect

If you are concerned about palpitations, talk with your health care provider about them. Your health care provider will listen and consider your age, your risk factors for heart disease, and any chronic conditions you may have. There are things your health care provider may want to know including:

Have you checked your pulse when you have palpitations? Does your pulse feel fast, slow, irregular, or regular? Does it feel like you skip beats? Note that some some fitness trackers and smart watches record pulse and arrhythmic beats.

Do you feel faint, dizzy, out of breath, or have aching or pain in your chest, neck, back or arm when you have palpitations?

Do they have a trigger? What are you doing or what else is happening when you have palpitations?

There are many different approaches your health care provider may take to evaluating your palpitations. This may vary from watchful waiting to tests to see what is causing these sensations. Potential tests include:

• An electrocardiogram (EKG): This is a recording of the electrical activity of your heart at rest. It evaluates your heart activity over a short period of time.
• A Holter Monitor: This is a device you wear on your chest for 24-48 hours to record a continuous EKG. There is usually a button you can press if you feel palpitations. Depending on how often you have them, this may or may not catch your palpitations.
• Echocardiogram – an ultrasound of the heart to evaluate the heart muscle and valves, and to see how the heart is pumping.
• Blood tests to evaluate your cardiac risk including blood lipids and blood sugar.

  Treatments that are inappropriate or have not been studied for this symptom are not listed.

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