From your health and wellness experts at Prisma Health
Health, Heart Health

When should you be concerned about heart palpitations

Columbia Heart

Does it feel like your heart is skipping beats, racing, fluttering or beating irregularly? If so, you might be experiencing heart palpitations. Palmetto Health-USC Medical Group cardiologist Lauren Holliday, MD, shared information about what they are and when you should seek treatment for them.

“Heart palpitations are one of the most common reasons people seek the advice of a cardiologist,” said Dr. Holliday. “While experiencing heart palpitations can cause worry, they are often harmless and brought on by anxiety, caffeine, fear, dehydration and other causes that can be managed.”

Dr. Holliday said it is important to seek medical attention to make sure they aren’t associated with a medical condition when they are accompanied by these symptoms:

  • Lightheadedness
  • Passing out
  • Shortness of breath
  • Chest pain
  • Sweating 

To determine the cause, your doctor may order one of several types of heart monitors. They include the following:

  • A holter monitor is usually used with frequent symptoms. It continuously monitors every heartbeat over the course of a 24- to 48-hour period.  
  • An event monitor is used with less frequent symptoms. Most event monitors allow you to push a button to activate the device so that your symptoms can be correlated with what's going on with your heart rate and rhythm at the time of the event you are experiencing.
  • A loop recorder is used when symptoms are infrequent but bothersome, worrisome or associated with other symptoms. This monitor is an implantable and is inserted under the skin. It can monitor your heart rhythm for up to three to four years, giving you the ability to record events when you have symptoms.

Dr. Holliday said the most common cause of palpitations is early heartbeats. There are also many types of abnormal heart rhythms, called arrhythmias, that can cause palpitations. One of the most common types of arrhythmias is atrial fibrillation (AFib). In some cases, it causes rapid and irregular heartbeats, and in some cases, it causes your heart to beat too slowly. If left untreated, it can lead to blood clots, stroke and heart failure.

AFib treatment is focused on controlling symptoms and reducing your risk of a stroke. For stroke prevention, blood thinners called anticoagulants are recommended for most people. AFib treatment options are:

  • Medication. If you are highly symptomatic, your cardiologist may start you on a medication to keep your heart in a normal rhythm or to help keep your heart rate under control. 
  • Ablation. You may also be a candidate for a procedure called an ablation where a highly specialized cardiologist uses a catheter-based procedure to target AFib hot spots with either burning heat or freezing cold. Ablation can significantly reduce, and in some cases eliminate AFib.
  • Pacemaker. If you are found to have a heart rate that is too slow, your cardiologist may recommend a pacemaker, which is an implantable device that helps regulate your heart rate.

“There are a lot of causes for heart palpitations, some which require further treatment and some which do not,” said Dr. Holliday. “The only way to know for sure whether the heart palpitations you are experiencing are associated with a more serious medical condition is to be evaluated by a doctor.” 

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