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Preventative Health: Unless they persist, heart palpitations are usually benign
Source: Harvard Health Letters

Have you ever experienced the sensation that your heart has skipped a beat or suddenly started to race or even pound? Those sensations are known as palpitations. While frightening, they're not usually a sign of something serious.

"Palpitations are most often benign in nature," says Dr. Peter Zimetbaum, a heart rhythm specialist and associate professor at Harvard Medical School. Still, palpitations occasionally may be a symptom of a potentially serious condition, so it's important to evaluate them.


Palpitations are very common. They can be caused by many things, such as caffeine, stress, or thyroid problems.

People describe different sensations as "palpitations": an occasional sudden and forceful "thump" in the chest, a pounding (but not rapid) heartbeat, a very rapid heartbeat, or a heartbeat that's not regular. Some people experience palpitations when they're upset or stressed. Others notice palpitations that don't seem related to any event or feeling; they simply appear out of the blue and then suddenly disappear.

So how do you know when palpitations warrant a visit to the doctor?

"Palpitations that are experienced as a fleeting symptom generally require no evaluation. Palpitations that last for more than a few seconds to minutes or are associated with lightheadedness or passing out should be evaluated thoroughly," explains Dr. Zimetbaum.


Some people are more likely to experience them, including people who:

1. Have heart problems such as heart failure, heart valve disease, previous heart attack, or cardiomyopathy

2. Take medications with stimulants such as thyroid medicines or those prescribed for asthma

3. Have high levels of anxiety or stress


Because palpitations come and go, your doctor will rely on other symptoms to help diagnose the underlying cause. You'll need to share information such as when the palpitations occur, how often, and what they feel like. You should mention additional symptoms if you have them, such as chest pain, a feeling of breathlessness, or lightheadedness.

It's also important to note how you were feeling emotionally when a palpitation occurred, and the activity you were performing.

After hearing about your symptoms, your doctor may order an electrocardiogram (ECG). In this test, technicians place small, thin metal plates (electrodes) on your chest to measure your heart's electrical activity. The test takes no more than a minute. Your doctor may have you wear a small monitor that records your heart rhythm for up to 48 hours.

If your palpitations are associated with chest pain or provoked by exertion, your doctor may order an exercise stress test. If your doctor is worried that you may have serious blockages in the arteries of your heart, he or she may order a coronary angiogram to take pictures of the arteries.

Once your doctor pinpoints the problem, treatment can begin. Sometimes the cause is an abnormality of the heart, such as atrial fibrillation (a heart rhythm disorder) or mitral valve prolapse (a leaky heart valve). Sometimes palpitations are the result of another condition such as anxiety or stress, a thyroid disorder, low blood sugar, asthma, or low potassium. Treating the underlying condition can often resolve the palpitations.


Stress, anxiety, or panic


Low potassium

Low blood sugar

Too much caffeine or alcohol



Standing up



Asthma medication

Thyroid medication

Other medications




If you are experiencing palpitations, it's important to take notes on your symptoms, how often they occur and when, and bring the notes with you to a doctor appointment. This information helps your doctor begin diagnose the cause of the palpitations.

If you notice that your palpitations aren't interfering with your daily life, try simple home remedies: practice meditation and relaxation exercises, cut back on caffeine and alcohol, make sure you eat regularly to avoid low blood sugar, and drink plenty of fluids to avoid dehydration. -- Harvard Health Letter


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