When to Go to the Doctor for Heart Palpitations

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The feeling of a sudden, rapid pounding in your chest is alarming — but heart palpitations are surprisingly common. They can occur because of everyday things, like chugging one too many cups of coffee in the morning, or they can signal something’s off with your heart. Dr. Talha Farid, UnityPoint Health, explains why heart palpitations happen, what they feel like, how to stop them and when to get checked out by a doctor.

What Causes Heart Palpitations?

There’s a laundry list of reasons someone might experience heart palpitations — from lifestyle factors, health conditions that aren’t heart conditions and abnormalities of the heart. Here are some common culprits that could send your heartbeat soaring.

Substance use, such as caffeine, alcohol and nicotine. Caffeine, alcohol and nicotine all have similar triggers for heart palpitations, because they each stimulate your nervous system and can make you feel like your heartbeat is irregular. You can also build up a tolerance to these substances, and the more you consume, the bigger the impact on your nervous system.

Dr. Farid says, “Smoking can also be associated with serious heart conditions, so if you’re experiencing palpitations, work with your doctor on a plan to quit.”

Medications. A range of prescription and over-the-counter medications are linked to heart palpitations. For instance, decongestants that help ease the symptoms of a stuffy nose contain pseudoephedrine or phenylephrine, two ingredients that can make your heart race or raise your blood pressure. Prescription medications used to treat asthma, hypothyroidism (low thyroid function) or hormonal treatments can cause heart palpitations, too.

Hormones. Women tend to experience heart palpitations more than men due to lower levels of estrogen experienced during menstruation and menopause. This dip in estrogen can overstimulate the heart, impacting your heartrate.

Emotional stress. Dr. Farid says it’s common to feel palpitations during times of anxiety or stress.

“If you’re panicking, feeling fearful or having any significant emotional response, palpitations can happen because your body automatically responds with an increased sympathetic surge in the nervous system, which is known to most people as ‘fight-or-flight response.’”

What do Heart Palpitations Feel Like?

Dr. Farid says heart palpitations can feel like your heart is skipping a beat, racing or pounding. Some people can feel palpitations in their chest; others feel them in their neck or throat.
He adds, “Some people can feel heart palpitations more than others, and your heartrate can be normal, or high, when they happen.”

What Does it Mean if You Get Heart Palpitations After Eating?

If you just finished your last bite of dinner and notice your heart beating faster than usual, there are a few reasons for that.

You’re normal. Dr. Farid says, “It may be just increased awareness of your heartbeat. After you eat, the heart rate sometimes goes up a little. The idea is the heart is working harder in that moment to supply your gut with blood to help digest your food.”

You have a heart arrhythmia. It’s well-known by doctors that abnormal heart rhythms can occur after eating. However, it’s not something you should ignore if it happens a lot.

“It could be a serious arrythmia. If you’re experiencing a fast heart rate after eating on a regular basis, the best thing to do is contact your physician.”

Low blood sugar. “Heart palpitations due to low blood sugar are activated by the same sympathetic surge in your nervous system that causes ‘fight or flight response’ — and that can cause a higher heartrate,” Dr. Farid says.

Spicy Food. The next time you order lunch with an extra side of jalapenos, you might notice your heartrate skyrocket. Dr. Farid says this response is kind of like what happens to your heart when you’re stressed, or your blood sugar is low. The activation of ‘fight or flight response’ is, once again, the culprit.

High sodium. A diet with too much salt can cause high blood pressure, which may cause heart palpitations.

Does COVID-19 Cause Heart Palpitations?

The short answer is yes, COVID-19 can definitely cause heart palpitations. However, Dr. Farid says the reason is often different depending on the person and their symptoms.

“We now know that COVID-19 can cause some degree of dysregulation in your nervous system and brain, sending signals to the heart to increase your heartrate. People with COVID-19 can also experience other abnormal heart rhythms, such as atrial fibrillation, which is more commonly seen after a diagnosis,” he says.

What Causes Heart Palpitations at Night?

Having more awareness of your heartbeat when you’re settled down in a quiet room is normal. If you’re lying on your left side with your left ear situated over your arm or hand, you’re in the perfect position to hear your heartbeat louder. Sometimes, that can feel like heart palpitations, although it’s nothing to worry about.

“There are some people who actually have abnormal heart rhythms more at night than during the day,” says Dr. Farid. “Some people have more atrial fibrillation during the night, and it actually keeps, or wakes, them up.”

There are a few other lifestyle factors that can impact a racing heart before you get some shuteye. Smoking a cigarette, exercising, drinking a cocktail, eating a sugary snack or feeling super stressed out can all cause the sensation of heart palpitations at night.

How Do You Help Stop Heart Palpitations?

First and foremost, Dr. Farid says if you’re having palpitations frequently, it’s best to seek medical attention and get to the bottom of why you’re having them. Start with your primary care doctor, who will likely refer you to a cardiologist to help with a diagnosis.

If you get the “all clear” after getting checked out, “then, yes, there’s stuff you can do to avoid heart palpitations,” he says.

Make some lifestyle changes. Start eliminating common triggers for a racing heartbeat. For example, avoid sugary drinks at night, don’t exercise close to bedtime, start a low sodium diet, minimize caffeine intake and limit alcohol consumption to decrease palpitations.

Try Vagal Maneuvers. These actions stimulate the vagal nerves, the system that controls your digestion, heart rate and immune system, and cause decreased electrical stimulation to the heart. This can result in slowing the heart rate and sometimes stopping irregular heartbeats.

Dr. Farid says there are several “vagal maneuvers” that can be used to slow down the heart and stop an irregular heartbeat. These include bearing down (simulating the same actions and pressure you would exert when trying to have a bowel movement), coughing, holding your breath or splashing cold water on your face.

When Should You Worry About Heart Palpitations?

If you’re feeling heart palpitations that won’t go away, happen more often and last longer, or you feel tired, short of breath, dizzy, lightheaded, or the palpitations are affecting your quality of life, it’s time to see your doctor.

“They will take a detailed history, perform a physical examination, and will order some non-invasive testing. Next steps will depend on the results, but you’ve already taken the right step in getting yourself checked out,” Dr. Farid says.

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