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Heart Palpitations: What to Know About Thumps, Flutters and Skipped Beats

Heart flutters and thumps can be scary, but they’re usually nothing to worry about. Here’s what you need to know.

Toni J. Brayer, M.D.

Contributor

Toni J. Brayer, M.D.

Sutter Pacific Medical Foundation

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 Pacific Medical Foundation, says. “Patients often become aware of their heart beat 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 are 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 are feeling OK, you are probably not experiencing a serious rhythm disturbance.”

Doctor listening to heart of white male patient

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. Exercise can also raise your heart rate as a normal response (while strengthening your heart muscle, as well as all your muscles).

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 Holter monitor or other event monitor for 24 to 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 are experiencing any serious irregularities or just a case of harmless flutters.

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