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Heart palpitations
Off-balance like floating
Shortness of breath
Have chest pain
Heart is beating fast and regularly
Irregular palpitations
Irregular heartbeat
Not seeing your symptoms? No worries!
Arrhythmias are issues with the rate or rhythm of your heartbeat, where it might beat too slowly, too fast, or with an irregular pattern. Benign arrhythmias are heartbeat irregularities that do not cause any symptoms. Causes include certain medications, caffeine, nicotine, alcohol, cocaine, inhaled aerosols, diet pills, stress, etc.
Your doctor may ask these questions to check for this disease:
Since it is asymptomatic, benign arrhythmias are usually monitored by a doctor without active treatment. Medications and other treatments may be needed for symptomatic arrhythmias.
Reviewed By:
Osler Jay Justo Guzon, MD (Cardiology)
Dr. Guzon graduated from the University of Missouri-Kansas City School of Medicine with a BLA and MD. He then completed his Internal Medicine Residency at St. Louis University before a fellowship in Cardiovascular Diseases at the University of Missouri-Columbia. He has since working as an invasive cardiologist with a particular interest in preventative medicine and cardiometabolic disease. Over the past several years, Dr. Guzon has served on the speaker bureaus of AstraZeneca, Lilly, Boehringer-Ingelheim, and Aralez.
Tatsuya Shiraishi, MD (Cardiology)
Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Q.
Heart Pounding? Why Verapamil Works & Medically Approved Next Steps
A.
Verapamil calms certain fast or irregular heart rhythms by limiting calcium entry in heart cells and slowing the AV node, easing palpitations from SVT, atrial fibrillation, and atrial flutter. There are several factors to consider, including who should not take it, possible side effects, and symptoms that require urgent care. Medically approved next steps include tracking episodes, addressing triggers, and getting ECG or heart monitoring to guide choices like beta blockers, verapamil, or ablation. See below for critical details that could change your safest next step.
References:
* Kasiyire, R., Löffler, L., Seiffarth, J., Steimle, A., von Kleist, M., Scholl, C., Schiroli, D., von Ungern-Sternberg, L., Maier, L., & Seidl, J. (2020). Pharmacology of Calcium Channel Blockers in Cardiovascular Disease. *International Journal of Molecular Sciences*, *21*(3), 830.
* Tan, N., Ma, C., Cao, Y., Xiong, L., Wei, L., & Wang, N. (2015). Calcium channel blockers for supraventricular tachycardia. *Cochrane Database of Systematic Reviews*, *(10)*, CD005051.
* O'Connor, M. J., Kumar, S., & Tedrow, U. B. (2017). Current pharmacological management of supraventricular tachycardias. *Expert Opinion on Pharmacotherapy*, *18*(10), 1017-1027.
* Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, D., Cuisset, C., Agewall, R., Dickstein, K., Edvardsen, T., Erglis, K. S., Fonseca, C., Gardner, R. S., Herbst, M., Kjeldsen, K. P. J., Lancellotti, P., ... Zamorano, J. L. (2017). 2017 ESC Guidelines for the management of stable coronary artery disease. *Circulation*, *135*(18), 1759-1772.
* Maron, B. J., & Maron, M. S. (2015). Management of Hypertrophic Cardiomyopathy. *Journal of the American College of Cardiology*, *66*(22), 2474-2488.
Q.
Heart Racing? Why Your Chest Is Fluttering & Vital Medical Next Steps
A.
Most heart racing and chest fluttering are benign palpitations from stress, caffeine, dehydration, poor sleep, or hormonal shifts, but they can also signal arrhythmias or issues like thyroid disease, anemia, or electrolyte problems; seek urgent care if they occur with chest pain, shortness of breath, fainting, or severe dizziness. There are several factors to consider; see below for practical first steps to calm symptoms, what patterns to track, when to schedule evaluation, the specific red flags, and how doctors diagnose and treat palpitations so you can choose the right next step.
References:
* Singh D, Singh H, Singh T, Singhal M, Singhal K, Sharma C, Bhatt S. Palpitations: Etiology, Diagnostic Approach, and Management. Cureus. 2023 Mar 19;15(3):e36338. doi: 10.7759/cureus.36338. PMID: 37089750; PMCID: PMC10115049.
* Al-Majali R, Al-Tamimi M, Al-Maitah M, Abu-Rumman A, Qasem H, Abusaq H. The Diagnostic Approach to Patients Presenting with Palpitations. Cureus. 2023 May 17;15(5):e38883. doi: 10.7759/cureus.38883. PMID: 37333036; PMCID: PMC10271705.
* Zimetbaum PJ. Palpitations: Evaluation and Management. J Clin Electrophysiol. 2020 Jan;31(1):5-10. doi: 10.1007/s10840-019-00627-w. Epub 2019 Sep 30. PMID: 31571171.
* Al-Ani M, Al-Ani M. Diagnosis and Management of Supraventricular Tachycardia. Cureus. 2023 Apr 15;15(4):e37637. doi: 10.7759/cureus.37637. PMID: 37197486; PMCID: PMC10189382.
* Kotecha D, Witte KK. Atrial Fibrillation: Clinical Presentation, Diagnostic Tests, and Prognosis. Heart Lung Circ. 2017 Jan;26(1):1-10. doi: 10.1016/j.hlc.2016.07.009. Epub 2016 Sep 2. PMID: 27599763.
Q.
Heart Racing? Why Your Human Heart Is Fluttering & Approved Next Steps
A.
Heart racing or fluttering is common and often harmless in the human heart, frequently triggered by stress, caffeine, dehydration, poor sleep, hormones, or normal exercise, but it can also indicate arrhythmias or other problems, especially if you have chest pain, shortness of breath, fainting, severe dizziness, or heart disease risk factors. Approved next steps include staying calm, drinking water, avoiding stimulants, using slow breathing, tracking triggers, and seeking urgent care for red flags or medical evaluation if episodes persist. There are several factors and nuances that could change your next step, so see the complete guidance below.
References:
* Ravindran N, et al. Palpitations: Evaluation and Management. Aust J Gen Pract. 2017 Jun;46(6):374-378. PMID: 28558486.
* Probst C, et al. Palpitations: an approach to diagnosis and management. BMJ. 2017 Nov 22;359:j5102. doi: 10.1136/bmj.j5102. PMID: 29162985.
* Al-Zaiti SS, et al. Supraventricular Tachycardia. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521287.
* Gopinathannair R, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Oct 3;82(14):e1-e209. doi: 10.1016/j.jacc.2023.04.018. Epub 2023 Aug 24. PMID: 37684019.
* Katon W. Cardiovascular manifestations of anxiety and panic attacks: a clinical review. Prim Care Companion J Clin Psychiatry. 2005;7(3):96-102. doi: 10.4088/pcc.v07n0302. PMID: 16013693.
Q.
Heart Racing? Why Your Heart is Fluttering from Dark Chocolate & Medically Approved Next Steps
A.
Dark chocolate can trigger heart fluttering in sensitive people because of caffeine, theobromine, and sometimes sugar, and in most cases the sensation is brief and harmless. There are several factors to consider, like your total stimulant intake, dehydration, anxiety, thyroid or rhythm disorders, medications, and hormonal shifts; see below to understand more. Medically approved next steps include cutting back on stimulants, logging what you ate and felt, hydrating and easing stress, and seeking care if palpitations are frequent, last over 20 to 30 minutes, or occur with chest pain, shortness of breath, fainting, or marked dizziness, with full guidance provided below.
References:
* pubmed.ncbi.nlm.nih.gov/29997782/
* pubmed.ncbi.nlm.nih.gov/31326084/
* pubmed.ncbi.nlm.nih.gov/24707719/
* pubmed.ncbi.nlm.nih.gov/30761274/
* pubmed.ncbi.nlm.nih.gov/33731301/
Q.
Heart Murmur? Why Your Heart Sounds Different & Medical Next Steps
A.
A heart murmur is an extra whoosh or swish from turbulent blood flow; many are harmless, but some point to valve or structural disease that needs proper evaluation, usually starting with an echocardiogram and urgent care for red flag symptoms like chest pain, fainting, or severe shortness of breath. There are several factors to consider, including your age, symptoms, likely cause, and whether monitoring, medication, or a procedure is best; see the complete guidance below to understand your next medical steps and important details for adults, children, and lifestyle.
References:
* Dames SG, Patel C, O'Connor M. Approach to the Patient With a Heart Murmur. Med Clin North Am. 2021 Jan;105(1):1-14. doi: 10.1016/j.mcna.2020.09.001. PMID: 33220803.
* Otto CM, Nishimura RA, Bonow RO, et al. 2021 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Sep 28;143(14):e72-e227. doi: 10.1161/CIR.0000000000000932. Erratum in: Circulation. 2021 Sep 28;143(14):e228. PMID: 33332721.
* Shurmur SW, Drazner MH, Cigarroa JE. Evaluation of Heart Murmurs in Adults: A Systematic Approach. Am J Med. 2017 Mar;130(3):288-294. doi: 10.1016/j.amjmed.2016.10.027. Epub 2016 Nov 16. PMID: 27866035.
* Nakanishi K, Feingold B, Zampi J. Distinguishing innocent from pathologic heart murmurs. Curr Opin Cardiol. 2020 Mar;35(2):98-106. doi: 10.1097/HCO.0000000000000707. PMID: 31868735.
* Sola-Del Valle DA, Smith JL, Helfrich PM. Heart Murmurs: An Update for Primary Care. Am Fam Physician. 2022 Sep;106(3):266-273. PMID: 36102144.
Q.
Confused by your EKG? Why your heart is skipping and the medical steps to take.
A.
There are several factors to consider about an abnormal EKG and a heart that feels like it is skipping, ranging from harmless premature beats to treatable arrhythmias like AFib or SVT and, less commonly, dangerous ventricular rhythms that need urgent care when paired with chest pain, fainting, or severe shortness of breath. Typical next steps include repeat EKG, wearable monitors, an echocardiogram, blood tests, and sometimes a stress test, along with lifestyle changes to reduce triggers. See the complete guidance below for warning signs, who should seek emergency help, and how your symptoms and risk factors shape the right plan.
References:
* Goodman S, et al. Palpitations: Evaluation and Management. Am Fam Physician. 2021 Oct 15;104(4):379-387. PMID: 34647788.
* Conen D, et al. Premature Ventricular Contractions: Clinical Significance and Management. Circ Arrhythm Electrophysiol. 2017 Jun;10(6):e005139. PMID: 28626084.
* Goyal A, et al. Supraventricular Tachycardia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Updated 2023 Aug 7. PMID: 28723028.
* Kusumoto FM, et al. Bradycardia and Bradyarrhythmias. Circ Arrhythm Electrophysiol. 2018 Aug;11(8):e006622. PMID: 30026214.
* Vlismas P, et al. Atrial Fibrillation: Pathophysiology, Clinical Features, and Management. Annu Rev Med. 2022 Jan 27;73:37-60. PMID: 34644026.
Q.
Heart Fluttering? Why Your Pulse Is Irregular + Medical Next Steps
A.
Heart fluttering and an irregular pulse are usually palpitations from an arrhythmia, often triggered by stress, caffeine, dehydration, or medicines, but they can also signal conditions like atrial fibrillation, supraventricular tachycardia, or other heart disease. Watch for red flags needing urgent care such as chest pain, shortness of breath, fainting, or severe dizziness, and discuss next steps with a clinician about tracking symptoms, ECG or Holter testing, blood work, and treatments from lifestyle changes and medications to procedures; there are several factors to consider, and key details that could change your plan are explained below.
References:
* Gillam, J. A., & Singh, R. M. (2021). Approach to Palpitations in Adults. *The American Journal of Medicine*, *134*(10), 1215–1221.
* Choy, J. B., & Singh, J. P. (2020). Diagnosis and Management of Atrial Fibrillation. *JAMA*, *324*(11), 1083–1084.
* Lin, K. Y., & Sung, R. J. (2021). Premature ventricular contractions. *Annals of Translational Medicine*, *9*(20), 1546.
* Hreybe, M., & Choxi, N. B. (2023). Supraventricular Tachycardia: Diagnosis and Management. *Current Treatment Options in Cardiovascular Medicine*, *25*(4), 117–129.
* Al-Khatib, S. M., & Pokorney, F. C. (2023). Diagnosis and Management of Bradyarrhythmias. *Current Treatment Options in Cardiovascular Medicine*, *25*(4), 130–140.
Q.
Heart Racing? Why Pseudoephedrine Affects Your Heart & Medical Next Steps
A.
Pseudoephedrine can make your heart race by stimulating the fight or flight system and tightening blood vessels, raising heart rate and blood pressure; effects are usually short-lived in healthy adults but can be significant if you have high blood pressure, heart disease or arrhythmias, are older, take higher doses, or combine it with caffeine or other stimulants. If your heart is racing, stop pseudoephedrine, avoid other stimulants, hydrate and rest, monitor symptoms, seek urgent care for chest pain, shortness of breath, fainting, severe dizziness, or a resting rate over 120, and ask your doctor about evaluation and safer congestion alternatives. There are several factors to consider; see below for important details on warning signs, who should avoid pseudoephedrine, medication interactions, and step by step next actions that could change your care plan.
References:
* Nandini, C., Naranjo, D. M., Saldivar, E. P., & Naddaf, H. M. (2022). Cardiovascular effects of pseudoephedrine: A systematic review and meta-analysis. *American Journal of Cardiovascular Drugs, 22*(3), 271-286. https://pubmed.ncbi.nlm.nih.gov/35165796/
* Khurana, P., Shah, J., Patel, P. R., & Naddaf, H. M. (2022). Pseudoephedrine and Phenylephrine: A Review of Cardiovascular Risk. *Current Cardiology Reviews, 18*(3), e060122201314. https://pubmed.ncbi.nlm.nih.gov/35260170/
* Johnson, D. A., & Degroot, J. L. (2018). Systemic effects of topical and oral decongestants: an update. *The American Journal of Medicine, 131*(9), 1017-1025. https://pubmed.ncbi.nlm.nih.gov/29906666/
* Salazar, A. G., & Naddaf, H. M. (2023). Cardiovascular safety of pseudoephedrine and phenylephrine: What's the latest? *Cleveland Clinic Journal of Medicine, 90*(4), 239-247. https://pubmed.ncbi.nlm.nih.gov/37012010/
* Hoffman, B. B. (2012). The pharmacology and cardiovascular safety of pseudoephedrine: a review. *Clinical Therapeutics, 34*(12), 2266-2274. https://pubmed.ncbi.nlm.nih.gov/23246227/
Q.
Heart Racing? Why Your Heart Skips and Medically Approved Next Steps
A.
Heart palpitations are common and often benign, triggered by stress, caffeine, dehydration, hormonal shifts, or medications, but there are several factors to consider and medically approved next steps include tracking symptoms, cutting stimulants, hydrating, prioritizing sleep and stress reduction, and seeing a clinician for ECG and monitoring when needed. Seek urgent care if palpitations occur with chest pain, shortness of breath, fainting, or severe dizziness, especially if you have heart disease risks; see below for key red flags, who is higher risk, what tests to expect, and step by step guidance that could change your next move.
References:
* Mandic DK, et al. Palpitations: Evaluation and Management. Clin Med Insights Cardiol. 2022;16:11795476221102980. doi: 10.1177/11795476221102980. PMID: 35706422; PMCID: PMC9190892.
* Katritsis ST, et al. The clinical approach to palpitations: a practical guide for clinicians. Europace. 2022 Dec 1;24(12):1853-1865. doi: 10.1093/europace/euac060. PMID: 35848529.
* Latchman AB, et al. Management of Premature Ventricular Contractions (PVCs). J Cardiovasc Transl Res. 2023 Dec;16(6):1480-1491. doi: 10.1007/s12265-023-10384-y. Epub 2023 May 10. PMID: 37166160.
* Katritsis DG, et al. Supraventricular Tachycardia: Diagnosis and Management. J Clin Med. 2021 Nov 16;10(22):5326. doi: 10.3390/jcm10225326. PMID: 34830155; PMCID: PMC8619665.
* Lin CC, Chung FP. Risk stratification of patients with palpitations. J Arrhythm. 2019 Jun;35(3):369-376. doi: 10.1002/joa3.12163. Epub 2019 Apr 12. PMID: 31223292; PMCID: PMC6570377.
Q.
Heart Racing? Why Your Heart Needs an Echocardiogram + Medically Approved Next Steps
A.
A racing or fluttering heart can be harmless or a sign of arrhythmias or structural disease; an echocardiogram is a safe ultrasound that checks chamber size, pumping strength, and valves to confirm whether your heart is structurally healthy. It does not diagnose rhythm directly, so ECG or a wearable monitor may also be needed; there are several factors to consider, and certain red flags can make an echo essential. Next steps include tracking symptoms and triggers, cutting stimulants, managing stress, and asking your clinician about ECG, labs, a Holter, and an echocardiogram, with urgent care for chest pain, fainting, severe shortness of breath, a resting rate over 130 to 150, or symptoms lasting more than 20 to 30 minutes. See the complete guidance below for important details that can change which steps you should take.
References:
* Shao C, Su X, Li C, Wang J, Shi Z, Yuan W, Li J. The value of echocardiography in the etiological diagnosis of palpitations. Echocardiography. 2021 Mar;38(3):527-533.
* Marcus GM. Evaluation and Management of Palpitations. N Engl J Med. 2022 Mar 3;386(9):863-872.
* Page RL, Joglar LA, Caldwell MA, Conti CM, Deal BJ, Estes NAM 3rd, Field ME, Goldberger ZD, Hammill PJ, Indik JE, Joglar JA, Kapa S, Kim RJ, Lipshultz BS, Lutchmedial PR, Noseworthy PA, Poole JE Jr, Stevenson WG, Varosy DJ. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019 Jun 18;139(24):e884-e902.
* Bhatia P, Patel T, Marston NA, Bisping E, Patel A, Desai A, Zimetbaum P, Chaitman B, Wenger NK, Maron BJ, Maron MS, Kwong RY. Diagnostic Echocardiography and Cardiac Magnetic Resonance Imaging for Assessment of Patients With Palpitations. JACC Cardiovasc Imaging. 2021 Oct;14(10):1930-1941.
* Douglas PS, Garcia MJ, Haines AN, Lapeyre LA 3rd, Masoudi FA, Pellikka PA, Picard MH, Smith EE, Waggoner AD, Walsh WF, Wann SL; American College of Cardiology Foundation; American Society of Echocardiography; American College of Emergency Physicians; American Heart Association; American Society of Nuclear Cardiology; Heart Failure Society of America; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Critical Care Medicine; Society of Cardiovascular Computed Tomography; Society for Cardiovascular Magnetic Resonance. ACCF/ASE/ACEF/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. J Am Coll Cardiol. 2011 Dec 13;58(24):2546-85.
Q.
Heart Fluttering? Why It’s Not Just Stress & Medically Proven EKG Next Steps
A.
Heart fluttering is often from benign palpitations due to stress, caffeine, dehydration, or poor sleep, but it can also signal arrhythmias like AFib or SVT that need evaluation. There are several factors to consider. A quick, painless EKG is the medically proven first step, with Holter or event monitors, wearables, blood tests, or an echocardiogram if symptoms persist; seek urgent care for chest pain, fainting, severe shortness of breath, or prolonged rapid heartbeats. See below for important details that can guide your next steps.
References:
* Pergolini, M., Iacopini, R., Pergolini, A., & Pergolini, P. (2022). Diagnostic Approach to Palpitations in Clinical Practice. *Journal of Clinical Medicine*, *11*(20), 6061.
* De Lorenzo, C., Iannone, F., D'Ettorre, S., Ciolli, A., D'Ovidio, R., & Cadeddu, C. (2023). The Assessment of Palpitations in Emergency Department Settings. *Journal of Clinical Medicine*, *12*(14), 4796.
* Katrancha, E. D., & Toth, P. P. (2021). Palpitations: Approach to Diagnosis and Management. *American Family Physician*, *103*(4), 226-234.
* Zimetbaum, P. J. (2018). Palpitations. *Medical Clinics of North America*, *102*(1), 57-69.
* Kalavakolanu, S., Bheemanathini, K., Kollipara, D., Saripalli, A., & Kalavakolanu, S. L. (2018). Ambulatory ECG monitoring in patients with palpitations. *Indian Heart Journal*, *70*(5), 713-718.
Q.
Heart Racing? Why Your Chest is Pounding + Carvedilol’s Medically Approved Steps
A.
Heart racing and chest pounding are often benign palpitations, but there are several factors to consider. Seek urgent care for chest pain, shortness of breath, fainting, or severe dizziness, and see below for causes, evaluation, and what to do next. Carvedilol, a beta and alpha blocker, can reduce palpitations by slowing heart rate and lowering blood pressure in conditions like hypertension, heart failure, and some arrhythmias, but it is not for occasional stress-related palpitations; medically approved steps for safe use are outlined below, including starting low with food, monitoring pulse and blood pressure, tapering instead of stopping, watching for side effects, and pairing with lifestyle changes.
References:
* Wong MC, Baranchuk A. Palpitations: Evaluation in the Office Setting. Am J Med. 2017 Jan;130(1):15-22. doi: 10.1016/j.amjmed.2016.07.039. Epub 2016 Sep 10. PMID: 27622877.
* Sharma S, Jayanandan L, Gupta A, Garg H, Kumar A, Rai AK, Upadhyay AD. Carvedilol: A Review of its Pharmacological Properties and Clinical Use in Cardiovascular Diseases. Int J Mol Sci. 2023 Mar 14;24(6):5501. doi: 10.3390/ijms24065501. PMID: 36982054; PMCID: PMC10051877.
* Heidenreich PA, Fintelmann JF, Hurwitz S, Maddox TM, Mandrola JM. Beta-blockers in Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2022 Mar 22;79(11):1075-1087. doi: 10.1016/j.jacc.2022.01.037. PMID: 35299440.
* Katritsis DG, Camm AJ. Diagnosis and management of common types of supraventricular tachycardia. Heart. 2020 Jul;106(14):1044-1051. doi: 10.1136/heartjnl-2019-315891. Epub 2020 Jan 20. PMID: 31959582.
* Whelton PK, Carey RM, Aronow WP, Casey DE Jr, Collins KJ, Himmelfarb CD, Kennedy DJ, Kimmel GA, Lackland GF Jr, Lima TE, Neaton JG, Patnode DE, Rosendorff G, Rossie SG, Simpson AE, Smith SC Jr, Stone NJ, Thomas RJ, Tindall DA, Volgman RB, Williamson JD, Wright JT Jr. Management of Hypertension: A Review. JAMA. 2020 Jun 2;323(21):2178-2190. doi: 10.1001/jama.2020.6590. PMID: 32483594.
Q.
Heart Palpitations After 65: Normal Aging or a Warning Sign?
A.
Palpitations after 65 are common and often harmless from things like extra beats, caffeine, dehydration, or stress, but frequent, new, or persistent episodes can also signal atrial fibrillation or other heart, thyroid, blood, or infectious problems; red flags like chest pain, shortness of breath, dizziness, or fainting need urgent care. There are several factors to consider, and evaluation and treatment range from lifestyle changes and medication review to ECG, blood tests, and heart monitoring, so see below for the full checklist of warning signs, what doctors look for, and practical next steps to guide your care.
References:
* Strait, J. B., & Lakatta, E. G. (2019). Aging and Cardiovascular Disease: A Review of Cellular and Molecular Mechanisms. *Frontiers in Physiology*, *10*, 1243. https://pubmed.ncbi.nlm.nih.gov/31680956/
* Camm, A. J., & Camm, J. (2013). Atrial Fibrillation in the Elderly: Risk Factors, Management, and Anticoagulation. *Arrhythmia & Electrophysiology Review*, *2*(2), 85–91. https://pubmed.ncbi.nlm.nih.gov/26834849/
* Krahn, A. D., Healey, J. S., & Benditt, D. G. (2013). Risk stratification of patients with palpitations: the Canadian Cardiovascular Society/Canadian Heart Rhythm Society position paper. *Canadian Journal of Cardiology*, *29*(4), 384–391. https://pubmed.ncbi.nlm.nih.gov/23537877/
* Das, J. K., Dhiman, N. P., & Das, S. K. (2017). Palpitations: Etiology, prognosis and management. *Indian Heart Journal*, *69*(1), S15-S22. https://pubmed.ncbi.nlm.nih.gov/28228308/
* Indik, J. H. (2017). Evaluation of the patient with palpitations. *Trends in Cardiovascular Medicine*, *27*(2), 117–123. https://pubmed.ncbi.nlm.nih.gov/27856002/
Q.
Heart Palpitations in Women: Anxiety or Heart Concern?
A.
Heart palpitations in women are often linked to anxiety, stress, or hormonal shifts, but they can sometimes signal arrhythmias or medical issues such as thyroid problems or anemia. Seek prompt care if they occur with chest pain, fainting, persistent shortness of breath, during exertion, last more than a few minutes, or if you have heart disease or a family history of sudden cardiac death; there are several factors to consider, and key details that can guide your next steps are outlined below.
References:
* Weber BE, Chung EK. Approach to the Patient With Palpitations. Am Fam Physician. 2018 Jun 1;97(11):727-735. PMID: 29851080.
* Bharmal A, Singh YK, Vashisht R, Kaur J. Common Causes of Palpitations and Their Evaluation. Cureus. 2020 May 2;12(5):e7930. doi: 10.7759/cureus.7930. PMID: 32483864; PMCID: PMC7264878.
* Sarapcioglu T, Toprak H, Ozturk Z, Uysal E. Anxiety and depression in patients with palpitations and normal heart. J Ment Health. 2016 Feb;25(1):79-83. doi: 10.3109/09638237.2015.1097237. Epub 2015 Nov 30. PMID: 26622434.
* Poudel S, Adhikari A, Thapa S, Singh M, Parajuli S, Thapaliya B, Khanal P, Koirala A. Cardiac Palpitations: Current Diagnostic and Management Strategies. Cureus. 2022 Oct 10;14(10):e30121. doi: 10.7759/cureus.30121. PMID: 36382025; PMCID: PMC9642284.
* Emami S, Vahidi-Moghadam B, Emami A. Prevalence of anxiety and depression in patients with cardiac arrhythmia. J Arrhythm. 2019 Feb;21(1):154-158. doi: 10.1007/s10840-019-00504-w. Epub 2019 Jan 30. PMID: 30704996; PMCID: PMC6370487.
Q.
Palpitations Over 65: When to See a Cardiac Specialist
A.
Adults over 65 should see a cardiac specialist when palpitations are new, frequent or worsening, last more than a few minutes, occur at rest or with minimal activity, or if there is a history of heart disease, stroke, or an abnormal EKG. Seek urgent care if palpitations come with chest pain, shortness of breath, dizziness, fainting or near fainting, sudden weakness or confusion, new exercise intolerance, or leg swelling. Brief, rare episodes that stop on their own and follow triggers like stress, caffeine, dehydration, poor sleep, or fever are usually less concerning, but there are several factors to consider; see below for tests, practical next steps, and treatment options.
References:
* Zègre-Hemsey JK, et al. Evaluation and management of palpitations in the elderly: a review. Am J Med. 2018 Oct;131(10):1153-1159. doi: 10.1016/j.amjmed.2018.06.014. Epub 2018 Jul 3.
* Hindricks G, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA). Eur Heart J. 2021 Feb 1;42(5):373-498. doi: 10.1093/eurheartj/ehaa612.
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Which is the best Symptom Checker?
Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Hannun, A. Y., Rajpurkar, P., Haghpanahi, M., Tison, G. H., ... (2019). Cardiologist-level arrhythmia detection and classification in ambulatory electrocardiograms using a deep neural network. Nature Medicine.
https://www.nature.com/articles/s41591-018-0268-3Priori, S. G., Wilde, A. A., Horie, M., Cho, Y., Behr, E. R., ... (2014). HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. Journal of Arrhythmia.
https://www.sciencedirect.com/science/article/pii/S1880427613001087Huizar, J. F., Ellenbogen, K. A., Tan, A. Y., & Kaszala, K. (2019). Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. Journal of the American.
https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.02.045