Heart Fluttering? Why Your Pulse Is Irregular + Medical Next Steps

If your heart feels like it's fluttering, skipping beats, racing, or pounding unexpectedly, you're not alone. These sensations are often described as palpitations, and they are commonly caused by an arrhythmia—a change in the normal rhythm of your heartbeat.

Sometimes an arrhythmia is harmless. Other times, it may signal an underlying heart condition that needs medical attention. Understanding the difference is key.

Below, we'll explain what arrhythmia is, why it happens, what symptoms to watch for, and what to do next.

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What Is an Arrhythmia?

An arrhythmia is an irregular heartbeat. Your heart normally beats in a steady, coordinated rhythm controlled by electrical signals. When those signals misfire or travel abnormally, your heart may:

• Beat too fast (tachycardia)
• Beat too slow (bradycardia)
• Skip beats
• Add extra beats
• Beat in an irregular pattern

Many arrhythmias are temporary and harmless. Others can affect blood flow and increase the risk of complications like stroke or heart failure.

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What Does Heart Fluttering Feel Like?

People describe arrhythmia symptoms in different ways, including:

• A fluttering sensation in the chest
• A racing heartbeat
• Skipped or extra beats
• A pounding pulse in the neck or chest
• A flip-flopping feeling
• Lightheadedness
• Shortness of breath
• Chest discomfort

It's important to note that not all arrhythmias cause symptoms. Some are found during routine exams.

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Common Causes of Arrhythmia

Arrhythmias can happen for many reasons. Some are temporary and triggered by lifestyle factors. Others are related to heart disease or other medical conditions.

1. Benign (Non-Dangerous) Causes

These are common and often temporary:

• Stress or anxiety
• Caffeine
• Alcohol
• Nicotine
• Dehydration
• Lack of sleep
• Fever
• Certain cold or asthma medications

In many healthy people, occasional extra beats (called premature atrial or ventricular contractions) are not dangerous.

If you're experiencing mild symptoms like fluttering, skipping beats, or occasional palpitations and want to understand whether they might be harmless, try this free Benign Arrhythmias (Palpitations) symptom checker to get personalized insights in minutes.

2. Heart-Related Causes

Some arrhythmias are linked to underlying heart conditions:

• Coronary artery disease
• Prior heart attack
• Heart failure
• Heart valve disease
• Congenital heart defects
• Cardiomyopathy (thickened or weakened heart muscle)

These arrhythmias may require ongoing medical care.

3. Other Medical Conditions

Certain health issues can also trigger arrhythmia:

• Thyroid disorders (especially hyperthyroidism)
• Electrolyte imbalances (low potassium or magnesium)
• High blood pressure
• Diabetes
• Sleep apnea

Treating the underlying problem often improves the arrhythmia.

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Types of Arrhythmias

There are several types, but the most common include:

Atrial Fibrillation (AFib)

• Irregular, often rapid heartbeat
• Increases stroke risk
• More common with age
• May require blood thinners

Supraventricular Tachycardia (SVT)

• Sudden episodes of rapid heartbeat
• Often starts and stops abruptly
• Can happen in younger, healthy people

Ventricular Arrhythmias

• Originate in the lower chambers of the heart
• Can be serious, especially after heart damage
• Require urgent medical evaluation

Bradycardia

• Heart rate that is too slow
• May cause dizziness or fainting
• Sometimes requires a pacemaker

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When Is an Arrhythmia Dangerous?

Most heart fluttering episodes are not life-threatening. However, certain symptoms require immediate medical attention.

Seek emergency care if you experience:

• Chest pain or pressure
• Shortness of breath
• Fainting or near fainting
• Severe dizziness
• Sudden weakness
• Confusion
• Symptoms lasting more than a few minutes and worsening

These could signal a serious arrhythmia, heart attack, or other emergency.

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How Doctors Diagnose Arrhythmia

If you report irregular heartbeats, your doctor may recommend:

1. Electrocardiogram (ECG or EKG)

• Records heart's electrical activity
• Quick and painless
• May detect arrhythmia during the test

2. Holter Monitor

• Worn for 24–48 hours
• Records heart rhythm continuously

3. Event Monitor

• Worn for weeks
• Activated when symptoms occur

4. Blood Tests

• Check thyroid function
• Evaluate electrolytes
• Look for signs of heart strain

5. Echocardiogram

• Ultrasound of the heart
• Evaluates structure and function

Diagnosis is important because treatment depends on the type and cause of arrhythmia.

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Treatment Options for Arrhythmia

Treatment varies widely. Some people need only reassurance and lifestyle changes. Others may need medication or procedures.

Lifestyle Changes

For mild or benign arrhythmias:

• Reduce caffeine and alcohol
• Quit smoking
• Manage stress
• Stay hydrated
• Improve sleep
• Treat sleep apnea if present

Medications

Depending on the type of arrhythmia:

• Beta blockers
• Calcium channel blockers
• Anti-arrhythmic drugs
• Blood thinners (especially for AFib)

These medications should always be taken under medical supervision.

Procedures

In some cases, doctors may recommend:

• Cardioversion – resetting heart rhythm with controlled electrical shock
• Catheter ablation – destroying small areas of heart tissue causing abnormal signals
• Pacemaker – for slow heart rhythms
• Implantable cardioverter-defibrillator (ICD) – for life-threatening ventricular arrhythmias

These treatments are typically reserved for persistent or high-risk cases.

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Can Anxiety Cause Arrhythmia?

Yes. Stress and anxiety can trigger palpitations and benign arrhythmias. The body releases adrenaline, which can:

• Increase heart rate
• Cause extra beats
• Create a fluttering sensation

However, it's important not to assume anxiety is the only cause without medical evaluation—especially if symptoms are new, worsening, or accompanied by other warning signs.

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How to Monitor Your Symptoms

If you notice irregular heartbeats, keep track of:

• When symptoms occur
• How long they last
• What you were doing at the time
• Any triggers (caffeine, stress, exercise)
• Associated symptoms (dizziness, chest pain)

This information helps your doctor identify patterns and determine next steps.

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The Bottom Line

Heart fluttering and irregular pulse sensations are often caused by an arrhythmia. In many cases, especially in otherwise healthy individuals, these episodes are benign and manageable with simple lifestyle changes.

However, arrhythmias can sometimes signal a more serious heart condition. The key is not to ignore persistent, severe, or concerning symptoms.

You should speak to a doctor if:

• Your symptoms are frequent or worsening
• You have underlying heart disease
• You have risk factors like high blood pressure or diabetes
• You experience dizziness, fainting, or chest pain
• You are unsure whether your symptoms are benign

While it's important not to panic, it's equally important not to dismiss ongoing heart rhythm changes.

If your symptoms are mild and you want a starting point, consider using a free, online Benign Arrhythmias (Palpitations) symptom checker to better understand what might be happening. It can help guide your next conversation with a healthcare provider.

Your heart rhythm matters. If something feels different, listen to your body—and when in doubt, speak to a doctor to rule out anything serious or life-threatening.