Your heart works harder than any other muscle, beating about 60 to 100 times per minute and over 14,000 times daily. But you probably don’t notice this unless it’s abnormal.

Heart palpitations are noticeable changes in your heart rate or rhythm. Often, they’re normal and harmless, but other times, they may signal a heart problem. Keep reading to learn what a dangerous heart rate is and when to get heart palpitations evaluated.

What Does a Heart Palpitation Feel Like?

During a heart palpitation, you become more aware of your heartbeat. It feels like your heart is racing or beating harder than usual. Heart palpitations might also feel like your heart skips a beat or has an extra beat.

You’re more likely to notice heart palpitations when sitting quietly or resting in bed. You can feel it in your chest, neck, or throat. Depending on what causes it, a heart palpitation can last a few seconds to several hours.

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Causes of Heart Palpitations

Everyone’s heart rate differs depending on age, physical fitness, and health. It also changes throughout the day, slowing when one rests and speeding up when one is active or moving.

A sudden, unexpected change in your heart rate is frightening, but it’s not always related to a heart problem. These things also affect your heart rate or rhythm:

  • Anxiety or stress.
  • Blood pressure changes.
  • Caffeine or alcohol.
  • Certain medications, like asthma drugs, decongestants, and heart or blood pressure medications.
  • Dehydration.
  • Exercise or physical exertion, like walking up a hill or a flight of stairs.
  • Hormone changes in women.
  • Nicotine.
  • Overactive thyroid.
  • Stimulant drugs, like cocaine or methamphetamine.

Aside from these, problems with your heart’s valves or electrical signals can cause palpitations due to an abnormal heart rhythm (arrhythmia). Some arrhythmias are severe and may need treatment because they increase your risk of heart attack, stroke, or heart failure.

What Is a Dangerous Heart Rate?

Adults’ average resting heart rate ranges from 60 to 100 beats per minute. It’s often lower if you’re physically fit or take heart or blood pressure medications to lower your heart rate. A normal heart rhythm is also even and consistent with that familiar “lub dub” pattern.

Talk to your doctor if you measure your heart rate and notice that it’s often fast or very slow. It’s also important to tell your doctor if you notice an abnormal or uneven heart rhythm, like skipping or having extra beats. You should also report any of these symptoms, which can signal a heart problem:

  • Chest pain or discomfort.
  • Fainting.
  • Frequent dizziness or lightheadedness.
  • Shortness of breath.

Your health care provider may evaluate you for these or other heart conditions:

  • Atrial fibrillation (a-fib). The most common cause of heart arrhythmia. It causes a fast and uneven heartbeat, which can cause blood to pool in the heart and possibly form clots. Atrial fibrillation increases your risk of stroke or heart failure.
  • Coronary artery disease. Plaque buildup in your arteries can reduce blood flow to your heart. Heart disease is a risk factor for arrhythmias.
  • Heart block. This refers to an abnormality in electrical signals passing through the heart’s normal electrical pathways. The abnormality “blocks” the electrical impulse from continuing through the normal pathways, causing a slower-than-normal heart rate.
  • Sick sinus syndrome. This condition happens when your heart’s sinus node, its natural pacemaker, doesn’t work correctly. Various irregular heart rates or combinations of arrhythmias can occur. Sick sinus syndrome can cause a slow heart rate or a combination of fast and slow heart rates.
  • Ventricular tachycardia (VT). A rapid heart rhythm, exceeding 100 beats per minute, originates in the lower chambers of the heart (ventricles). Some forms of VT may worsen and lead to ventricular fibrillation, a life-threatening condition that can cause cardiac arrest.

Evaluating Heart Palpitations

Heart palpitations are rarely serious, but reporting them to your health care provider is still crucial. Sometimes palpitations will go away with:

  • A change in medication.
  • Reducing alcohol or caffeine.
  • Stress management techniques like meditation or breath work.
  • Treating an underlying health problem, like anemia or an overactive thyroid.

To check for heart problems, your doctor may order these or other tests:

  • An electrocardiogram (EKG or ECG). This test checks for problems with your heart’s electrical system. It applies electrodes (small sticky patches) to your chest. The electrodes connect to a machine that traces your heart’s activity onto a paper printout.
  • A Holter monitor. This portable EKG also applies electrodes to your chest, but you carry it in your pocket. You wear the electrodes for several days while recording your activities and any symptoms. Because you can’t predict when heart palpitations will happen, the test allows your doctor to monitor your heart for an extended period.

Treatments for Heart Palpitations or Arrythmias

If heart palpitations require treatment, your health care provider might recommend the following:

  • Cardiac ablation. With this minimally invasive procedure, the doctor threads a catheter (a thin, flexible tube) into a vein and to your heart. Electrodes on the catheter destroy tiny areas in your heart that are firing off abnormal electrical impulses and causing palpitations.
  • An implantable cardioverter-defibrillator (ICD). This small, battery-powered device constantly monitors your heart rate and fires a shock to restore normal heart rhythm when necessary. A doctor implants the ICD under your skin, usually in your upper chest. They use a catheter to connect the ICD lead (wire) to your heart.
  • A pacemaker. This is a tiny, battery-powered, computer-like device that regulates your heartbeat. A doctor uses a catheter to connect the pacemaker lead to your heart. They’ll permanently implant the pacemaker itself under your skin, usually in your upper chest.

Heart palpitations are very common and usually not serious. Still, you should talk to your doctor if they happen frequently. They can check your heart and address any underlying health conditions to keep you healthy and active.

MedlinePlus. Heart Palpitations. Link

American Heart Association. Tachycardia: Fast Heart Rate. Link

American Heart Association. Bradycardia: Slow Heart Rate. Link

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.