An overview of heart palpitations from Mayo Clinic

Almost everyone feels occasional heart palpitations -- a change in the heart's rhythm. Palpitations range from what feels like a skip, flip or bump in the heart's rhythm to a sustained, racing heartbeat.

The July issue of Mayo Clinic Health Letter provides an overview of heart palpitations, including when emergency care is needed, what diagnostic tests are used and common triggers.

Most often, heart palpitations are harmless, but not always. Palpitations can be a sign of an underlying serious problem such as heart disease, an overactive thyroid gland or anemia. Rarely, tumors can produce certain hormones that can cause heart palpitations.

Emergency care is recommended when palpitations are accompanied by chest pain or fainting, or if they involve a racing heart that doesn't slow to a normal pace within about 20 minutes.

Palpitations, along with light-headedness, shortness of breath or a feeling of dizziness, or a racing heart that returns to normal on its own, are not considered medical emergencies but should be checked out with a physician.

To determine the underlying cause of palpitations, diagnostic tests might include a blood test to check for health concerns and a chest X-ray or echocardiogram to view the structure and function of the heart. An electrocardiogram (ECG) recording of the heart is generally recommended, too. Some patients are given ECG monitors to wear at home for one to three days in the hope of recording the heart during a palpitation episode.

Treatment varies greatly depending on the underlying cause of the palpitations. A doctor may also suggest ways to address possible palpitation triggers that can include:

• Stress, anxiety or panic
• Strenuous exercise
• Caffeine, nicotine and alcohol
• Any medication or supplement that acts as a stimulant, such as cold medicines containing pseudoephedrine, certain asthma medications or diet pills
• Fever
• Hormone changes associated with menopause
• Dehydration
• Thyroid abnormalities