Heart Fluttering or Skipping Beats? Top Cardiologists Explain What’s Normal and When to See a Doctor
Experts explain what causes heart palpitations, when to seek help and how to stop them naturally
Ever had that moment where it feels like your heart skips a beat? This might occur after a stressful day, a burst of exciting news, meeting someone new or even drinking your morning coffee. And sometimes, these heart palpitations seemingly happen for no reason at all. While it can be a weird, unsettling feeling, most of the time it’s harmless. However, understanding when to worry about heart palpitations can help you separate innocent flutters from serious health concerns. We consulted with cardiologists to clarify what’s considered regular cardiac activity and when symptoms may indicate something more serious that requires medical attention.
What are heart palpitations?
Palpitations are symptoms of fluttering or skipping heartbeats within the chest. They are very common, and most people experience them at some point. Still, they typically occur when there are variations in the heart rhythm, explains Bradley Serwer, MD, interventional cardiologist and chief medical officer at VitalSolution.
Premature heartbeats or sudden-onset rapid rhythms often cause heart palpitations. “Premature beats can originate from the top part of the heart (the atria) and are called premature atrial contractions (PACs), or from the bottom of the heart (the ventricles), known as premature ventricular contractions (PVCs),” says Dr. Serwer.
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They can also be triggered by stress, electrolyte imbalances, caffeine, nicotine or other heart conditions. He adds that abnormal heart rhythms such as atrial fibrillation (AFib), supraventricular tachycardia (SVT), ventricular fibrillation (V-fib) or ventricular tachycardia (VT) can also cause palpitations. Sometimes, these abnormal rhythms are brief and resolve naturally, but at other times, they can persist and lead to fainting or potentially even be life-threatening.
Who experiences heart palpitations?
One in four people will experience heart palpitations regularly. Palpitations can affect anyone, but women—especially during hormonal shifts like pregnancy or menopause—report them more often, notes Jayne Morgan, MD, cardiologist and VP of medical affairs at Hello Heart.
She says you may feel them during or after intense exercise, during anxiety or panic attacks, after consuming too much caffeine or alcohol or even while lying down or turning over in bed.
When to worry about heart palpitations
It can be challenging to tell if heart palpitations signal a serious health concern. “If they’re frequent, particularly if they last more than a few minutes, or if they are associated with symptoms such as chest pains, shortness of breath or breathing difficulties, dizziness, lightheadedness or passing out, then you should see your doctor for evaluation,” says Cliff Berger, MD, chief of cardiology at Beth Israel Deaconess Hospital-Needham.
Dr. Serwer says it’s also important to identify the underlying cause of the palpitations. If they’re due to premature heartbeats, they’re usually benign. However, “if they stem from an abnormal heart rhythm like atrial fibrillation, there may be a higher risk of complications such as stroke or congestive heart failure.”
How to monitor heart palpitations
Not sure if your heart palpitations are normal? Dr. Berger recommends keeping track of them with a heart monitor. In the past, that meant wearing a device such as a Holter monitor that records the heart’s rhythm for 24 hours or even up to 30 days. Today, smartwatches and other at-home devices make real-time monitoring and recording episodes easier, so you can share detailed data with your healthcare provider.
He suggests noting specific irregularities, such as whether the rhythm feels uneven, how long the palpitations last and if any of the symptoms mentioned above accompany them.
How to stop heart palpitations naturally—and what to do
If you’re experiencing heart palpitations regularly, our cardiologists recommend the following measures:
- Consult with your doctor: It’s crucial to discuss the palpitations and your medical history with a medical provider to see if there is a reversible cause. “This may be a medicine that was taken over the counter or even prescribed,” Dr. Serwer says.
- Avoid exacerbating the symptoms: Dr. Swerwer suggests cutting out caffeine, stimulants, tobacco or alcohol. Additionally, any over-the-counter medications with decongestants have stimulants that can make palpitations worse and increase your heart rate.
- Stay hydrated: You want to ensure that you’re drinking enough water throughout the day to help your heart function smoothly. (Discover how much water you need daily here.)
- Reduce stress: Dr. Morgan says managing stress by taking time to relax and recharge is key. You can do this by practicing deep breathing exercises, yoga or meditation.
- Review your family history: Talk to your family about any record of heart conditions. “Many cardiac issues can be inherited and may first appear as palpitations, so identifying them early can make a big difference in treatment and long-term outcomes,” says Dr. Swerwer.
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