What Do Palpitations Feel Like? Understanding Heart Fluttering and Skipped Beats

Heart palpitations are a common experience, often described as a noticeable fluttering, pounding, or racing sensation in your chest. These sensations can be unsettling, and understanding what palpitations feel like is the first step in determining whether they are a cause for concern. While palpitations are often harmless and triggered by everyday factors, they can sometimes indicate an underlying heart condition known as arrhythmia.

To understand palpitations, it’s helpful to know about heart arrhythmias. A heart arrhythmia is simply an irregular heartbeat. This occurs when the electrical signals that coordinate your heartbeats don’t function correctly, leading to a heart that may beat too fast, too slow, or in an erratic pattern.

Typical Heartbeat

Alt text: Diagram illustrating a normal heart rhythm with electrical signals flowing from the sinus node through the atria, AV node, and ventricles.

In a typical heartbeat, a small group of cells called the sinus node initiates an electrical signal. This signal travels through the upper chambers of the heart (atria) to the atrioventricular (AV) node, and then down to the lower chambers (ventricles). This coordinated electrical activity causes the heart muscles to contract and pump blood efficiently throughout the body.

When this electrical system is disrupted, it can lead to an arrhythmia, and you may become aware of your heartbeat in the form of palpitations.

Types of Heart Arrhythmias

Heart arrhythmias are broadly categorized by the speed of the heart rate:

• Tachycardia: This refers to a fast heartbeat, generally defined as a heart rate exceeding 100 beats per minute.
• Bradycardia: This indicates a slow heartbeat, where the heart rate falls below 60 beats per minute.

Palpitations can occur with both tachycardia and bradycardia, as well as with other types of irregular heartbeats.

Symptoms of Palpitations: What You Might Feel

“What Do Palpitations Feel Like?” is a frequently asked question, and the answer is quite varied as the sensation can differ from person to person. Here are common descriptions of what palpitations can feel like:

• Fluttering in your chest: Many people describe palpitations as a fluttering sensation, almost like butterflies in their chest. It can feel like your heart is briefly quivering or vibrating.
• Pounding heart: Palpitations can manifest as a forceful pounding in your chest. You may feel each heartbeat as a strong, distinct thump.
• Racing heart: This is a sensation of your heart suddenly speeding up, beating much faster than usual. It can be accompanied by a feeling of unease or anxiety.
• Skipped beats: You might perceive palpitations as your heart skipping a beat, followed by a more forceful beat. This can feel like a momentary pause in your heart rhythm.
• Flip-flopping sensation: Some describe palpitations as a flip-flopping feeling in the chest, as if the heart is turning over or out of rhythm.
• Thumping in the neck or throat: In some cases, the strong heartbeats associated with palpitations can be felt not only in the chest but also as a thumping or pulsing in the neck or throat.

It’s important to note that the intensity and duration of these sensations can vary greatly. Palpitations may last for a few seconds, minutes, or even longer. They may occur infrequently or happen more often.

Other symptoms that may accompany palpitations include:

• Chest discomfort: Palpitations can sometimes be associated with mild chest pain or discomfort.
• Shortness of breath: You might feel slightly breathless or experience difficulty catching your breath during palpitations.
• Dizziness or lightheadedness: In some cases, palpitations can cause dizziness or lightheadedness, especially if the heart rate is significantly affected.
• Anxiety: The sudden and sometimes alarming nature of palpitations can trigger feelings of anxiety or unease.
• Sweating: You might experience increased sweating along with palpitations.
• Fatigue: Feeling unusually tired can sometimes accompany palpitations.
• Fainting or near-fainting: In more severe cases, palpitations can lead to fainting or near-fainting episodes, particularly if caused by a serious arrhythmia.

When to Worry About Palpitations and Seek Medical Help

While occasional palpitations are often benign, it’s crucial to know when to seek medical attention.

Seek emergency medical care immediately if you experience palpitations along with any of these symptoms:

• Chest pain: Especially if the pain is severe, crushing, or radiating to the arm, jaw, or back.
• Shortness of breath: Significant or sudden onset of shortness of breath.
• Fainting or loss of consciousness: If you faint or feel like you are about to faint.

Schedule a health checkup if you experience palpitations that are:

• Frequent: Palpitations that occur often.
• Bothersome: Palpitations that cause you significant discomfort or anxiety.
• Worsening: Palpitations that are becoming more frequent or intense.
• Occurring with other symptoms: Palpitations accompanied by any of the symptoms mentioned earlier like dizziness, chest discomfort, or shortness of breath (even if not severe).

It’s always best to err on the side of caution when it comes to heart health. Consulting a doctor, especially a cardiologist (a heart specialist), can help determine the cause of your palpitations and ensure you receive appropriate care if needed.

Causes of Heart Arrhythmias and Palpitations

Various factors can disrupt the heart’s electrical system and lead to arrhythmias and palpitations. These include:

• Heart conditions: Existing heart problems like coronary artery disease, heart attack, heart valve disease, heart failure, and cardiomyopathy increase the risk of arrhythmias.
• High blood pressure: Hypertension can contribute to heart damage and increase the likelihood of arrhythmias.
• Congenital heart defects: Heart problems present at birth can affect heart rhythm.
• Thyroid disorders: Both overactive and underactive thyroid glands can impact heart rate and rhythm.
• Obstructive sleep apnea: This sleep disorder can lead to irregular heartbeats.
• Electrolyte imbalances: Imbalances in electrolytes like potassium, sodium, calcium, and magnesium can interfere with heart signaling.
• Certain medications and substances: Some prescription drugs, over-the-counter cold remedies, alcohol, caffeine, nicotine, and illegal drugs can trigger arrhythmias.
• Stress and anxiety: Emotional stress and anxiety can contribute to palpitations.
• Other factors: Diabetes, COVID-19 infection, genetics, and smoking are also risk factors.

Complications of Heart Arrhythmias

The potential complications of heart arrhythmias depend on the type and severity of the arrhythmia. Some possible complications include:

• Blood clots and stroke: Certain arrhythmias, like atrial fibrillation, can increase the risk of blood clots forming in the heart, which can travel to the brain and cause a stroke.
• Heart failure: Some arrhythmias can weaken the heart over time and lead to heart failure.
• Sudden cardiac death: Ventricular fibrillation, a dangerous type of arrhythmia, can cause sudden cardiac death.

Prevention of Heart Arrhythmias

Adopting a heart-healthy lifestyle can help prevent heart arrhythmias and manage palpitations. Key preventive measures include:

• Don’t smoke: Smoking is detrimental to heart health.
• Eat a heart-healthy diet: Focus on a diet low in salt and saturated fat, rich in fruits, vegetables, and whole grains.
• Exercise regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
• Maintain a healthy weight: Obesity increases the risk of heart problems.
• Manage stress: Practice stress-reducing techniques like yoga, meditation, or deep breathing.
• Control blood pressure, cholesterol, and diabetes: Effectively manage these conditions if you have them.
• Get adequate sleep: Aim for 7-9 hours of quality sleep per night.
• Limit or avoid caffeine and alcohol: These substances can trigger palpitations in some individuals.

By understanding “what do palpitations feel like” and taking proactive steps to maintain heart health, you can better manage your well-being and address any concerns with your healthcare provider.

By Mayo Clinic Staff

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Oct. 13, 2023

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