What happens when I feel palpitations in my chest?

Most of the time heartbeats go unnoticed. However, in some cases, a fluttering, racing, pounding, or jumping sensation may be felt in the chest, throat, or neck. Heart palpitations are abnormally rapid or irregular heartbeats that can occur for a variety of cardiac and non-cardiac reasons:

Non-cardiac causes:

• Physical exercise.
• Substance consumption: caffeine, alcohol, nicotine, stimulants such as cocaine and amphetamines.
• Hormonal: thyroid dysfunction, pregnancy, menopause, menstruation.
• Certain medicines (asthma, thyroid problems, decongestants, nutritional or herbal supplements).
• Lack of sleep.
• Dehydration
• Fear, anxiety, stress.
• Fever
• Anemia

Cardiac causes:

• Arrhythmias
• Heart failure.
• Valvular diseases.
• Cardiomyopathies.

How do palpitations happen? 

The heart is a muscle that works like a pump, contracting and relaxing to transport blood to all the cells of the body. On average, the heart beats 60 to 100 times per minute. A specialized electrical conduction system is responsible to originate the heartbeat. The electrical impulse travels through the heart resulting in the contraction of the heart muscle. Therefore, any stimulus that interferes with or affects this conduction system will probably result in a heart rhythm abnormality.
 

Diagnostic 

Diagnosing and finding the cause of heart palpitations is not an easy task. Usually, at the time of consultation, palpitations are not present. However, the physician will perform a thorough history and complete physical examination to detect any abnormalities. Several tests (blood, urine), an electrocardiogram, an echocardiogram, a Holter monitor (wearable device to record heart's electrical activity for 24-48 hours) can be very useful in the diagnosis, although sometimes more specialized tests will be needed as well as a referral to a cardiologist.

Treatment 

In most cases, non-cardiac palpitations do not need a specific treatment. Lifestyle changes such as reducing stress (meditation, relaxation, yoga) and avoiding stimulating substances (caffeine, drugs, alcohol, etc.) may help to reduce or eliminate this symptom. However, when the cause of palpitations is related to a heart problem, for example, arrhythmias, a treatment focused on correcting the heart rhythm abnormality will be needed.
 

When do I need to go to the emergency room? 

You should go to the nearest emergency room if you have palpitations and any of these symptoms: 

• Dizziness
• Confusion.
• Fainting
• Difficulty breathing
• Chest pain or discomfort spreading to your neck, jaw or arms.