“Doctor, I’ve been feeling this fluttering sensation in my chest and it’s very scary. Am I having serious heart trouble?”
I tell this thirty-something young woman that this is not uncommon. As a cardiologist, heart palpitations are one of the most frequent reasons that people call me or come to see me. Palpitations are simply an awareness of your heart beat, usually felt in the chest or throat and often variable and difficult to describe – flopping like a fish, fluttering like a butterfly, pounding, throbbing, racing, quivering. You are usually aware of them when you run up a flight of stairs. Typically they are not serious. It’s important to know that you can have a perfectly healthy heart and experience palpitations.
Here are some of the most common causes of heart palpitations:
- emotional stress
- over- the-counter medications such as Sudafed (a drug I never prescribe because of this side effect)
- drugs such as diet pills, cocaine and nicotine.
- certain medical conditions might prompt palpitations: overactive thyroid, anemia, and mitral valve prolapse (the last being, almost always, benign.)
Most of the time, reducing caffeine or stress will reward you with a quiet heart. Cut out caffeine – coffee, chocolate, cola drinks. Manage your stress- consider yoga, tai chi, or meditation. And if you find your skipped beats come at night when you’re in bed, try rolling over onto your right side, where the heart is not so close to the chest wall.
When should you call your doctor?
For individuals who have had a previous heart attack, valvular abnormalities or arrhythmias, it is important to set up an appointment with your doctor. Additionally, if this is a new symptom without a probable cause, call your doctor. Your doctor will likely do some testing: EKG, echocardiogram, ambulatory heart monitoring or stress testing.
Questions your doctor may ask include:
- Describe the palpitation: Put your hand on your chest and mimic the sensation.
- How often do you get palpitations?
- How long do they last?
- What do you think provokes them?
- Do they occur at rest or with exertion?
- Do they begin and end suddenly or gradually?
- What relieves them?
Now if your doctor gives you a clean bill of health, you would do well to ignore the palpitations as best you can. If that’s not possible, there are medications that can be helpful.
An update on my patient who began this discussion: she’s fine. “Thanks,” she said, “Now I can tell my boyfriend, I’m OK.”
“Right,” I told her, “You’re not sick; you’re just in love.”