Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.
The heart's rhythm may be normal or abnormal when you have palpitations.
Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing
Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise routinely or take medicines that slow the heart.
If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.
Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.
The following conditions make you more likely to have an abnormal heart rhythm:
Heart palpitations can be due to:
However, some palpitations are due to an abnormal heart rhythm, which may be caused by:
Things you can do to limit palpitations include:
Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
If you have never had heart palpitations before, see your provider.
Call 911 or the local emergency number if you have:
Call your provider right away if:
Your provider will examine you and ask questions about your medical history and symptoms.
You may be asked:
An electrocardiogram may be done.
If you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.
If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:
Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 10.
Miller JM, Tomaselli GF, Zipes DP. Diagnosis of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli, GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 35.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.