Heart Palpitations: What To Know

Have you ever experienced a racing heart rate, irregular pulse or the sense that your heart skipped a beat and wondered if it’s serious?

“It’s one of the most common concerns that patients have,” Toni Brayer, M.D., an internal medicine doctor at Sutter, says. “Patients often become aware of their heartbeat and wonder if it’s normal. During menopause, for example, women may feel more random, irregular heartbeats, or the sensation of the heart skipping a beat. Other times a racing heart can just come out of nowhere.”

If you’re worried, the first thing to do is sit down, relax and then take your pulse, Dr. Brayer recommends. “Count the beats of your heart for 15 seconds and multiply by four to get your heart rate. If it’s under 100 beats per minute, and you're feeling OK, you’re probably not experiencing a serious rhythm disturbance.”

In contrast, if your resting pulse suddenly rises to 100 beats per minute or more, that can be a sign of tachycardia — a more serious disturbance in the rhythm of the heart. You should also be concerned if you are feeling irregular beats or a racing heart and also feel light-headed, dizzy or otherwise “wrong.”

Take a few minutes to get familiar with heart attack symptoms. If you notice any of these symptoms, call your doctor right away or head to the emergency room, Dr. Brayer says.

What Causes Heart Fluctuations?

Irregular beats can be caused by medications, fluctuations in hormone levels and stress — without evidence of any underlying heart disease. An elevated heart rate is a normal response to exercise.

When to See Your Doctor

If you are concerned about your heart palpitations, see your doctor. A few simple tests can often rule out major heart issues. “Your doctor can tell a great deal by taking a good history of your symptoms, reviewing your medications, including over-the-counter medications, and examining your heart and vessels,” Dr. Brayer says.

Your doctor might also suggest that you wear a heart monitor for 24-72 hours. These devices record the electrical activity of the heart, while the wearer keeps a journal of any unusual heart rhythms. This information will help your doctor see if you’re experiencing any serious irregularities or just a case of harmless flutters.