Cedars-Sinai Blog
Why Is My Heart Racing?
It’s normal for your heart to beat faster or pound harder when you’re scared, excited or exercising. But what does it mean if your heart does these things while you’re at rest?
Heart palpitations can be harmless, but in some cases—especially if you have a history of heart disease—they could be a sign of a potentially serious condition known as a cardiac arrythmia. Here, Ashkan Ehdaie, MD, a cardiac electrophysiologist at the Smidt Heart Institute at Cedars-Sinai, explains when you should see a doctor about racing heart symptoms.
"For patients who are older or have chronic conditions, [heart palpitations] can be a serious issue, and doctors should be vigilant about monitoring the patients’ hearts and offering solutions."
Ashkan Ehdaie, MD
What Is a Heart Palpitation?
A heart palpitation is a sudden feeling that your heart is pounding harder or faster than usual, pausing or skipping a beat, or beating extra heartbeats. They can be triggered by dehydration, increased caffeine intake, certain medications or even a poor night of sleep. Usually, heart palpitations aren’t harmful to your health.
If you have heart palpitations that concern you, a doctor can help by asking specific questions to get a precise understanding of your symptoms.
"Palpitations could be different for every single person, so we have to know exactly what you’re feeling and describing," Ehdaie said. "They can range from extremely benign to extremely dangerous."
Feeling like your heart has an extra beat or skips a beat is not unusual, and usually not a cause for concern, Ehdaie said. These types of palpitations are often caused by extra heartbeats from the bottom chambers of the heart, which are called premature ventricular contractions (PVCs).
"PVCs are very common. Many people don’t feel them, but if I put monitors on people on the street, most will have a handful in a day," he said.
When Heart Palpitations May Be a Sign of Serious Illness
If you experience heart palpitations and you’re also fainting, or if you’ve ever had a heart attack or cardiovascular disease, testing can rule out more serious conditions, such as atrial fibrillation (AFib), an arrhythmia that could lead to stroke or other heart problems. Doctors can perform an electrocardiogram (EKG) and ultrasound of the heart to look for heart muscle and valve problems. Sometimes, an MRI is necessary so clinicians can look for scar tissue in the heart. Scarring could be indicative of a dangerous arrythmia that could cause cardiac arrest.
A doctor may ask you to wear a heart monitor, which is like a big bandage over the left side of your chest, while you go to work, exercise and sleep for a few days, Ehdaie said. Then, the doctor will analyze your heartbeats—about 1.2 million in that time frame—to determine how often your heart beats abnormally.
Doctors will also determine whether heart palpitations are caused by other medical conditions, such as overactive thyroid, which can increase a person’s risk of developing Afib and stroke.
The results of tests and monitoring will guide doctors in diagnosing an arrhythmia or other condition so they can explain whether you could benefit from medications or procedures.
When to Talk to Your Doctor
An occasional heart palpitation for a few seconds is usually harmless. But talk with your doctor if you’re concerned about a racing, fluttering or skipping heart that happens often or for a prolonged period—especially if you have a history of heart attack, or you have diabetes, high blood pressure, high cholesterol or obesity.
Some serious arrhythmias, such as AFib, may be underdiagnosed because they don’t happen often, Ehdaie said.
"Everyone is different. Some patients are very sensitive, and others don’t notice an elevated heart rate or an abnormal heartbeat because it doesn’t happen often," he said. "For patients who are older or have chronic conditions, it can be a serious issue, and doctors should be vigilant about monitoring and offering solutions."
