The Irish Heart Foundation’s Helpline Nurse Bernadette Bergin, explains all you need to know about heart palpitations.

At the Irish Heart Foundation, we aim to provide accurate and evidence-based information on heart health to help you make informed decisions about your health.

One topic that we get a lot of queries about is heart palpitations. Luckily, our Helpline Nurse Bernadette Bergin is on hand to explain all you need to know about this common occurrence.

Bernadette explained that a normal heartbeat has a steady, regular rhythm and a normal resting heartbeat is between 60 to 100 beats a minute.

Our heart rate can speed up and slow down depending on our activity levels, whether we’re eating or drinking, or when we’re stressed or anxious. However, most of the time we are completely unaware of our heart beating.

What are palpitations and how common are they?

A palpitation is the sensation we get when we can feel our own heart beating, and/or an awareness of a change from the steady, regular rhythm of our hearts. Bernadette explained that palpitations are a common occurrence, usually nothing to worry about and something most people would experience from time to time during their lifetime.

What do palpitations feel like?

If you have never noticed them before, palpitations can be alarming.

“They are for sure a nuisance, and sometimes can feel quite unpleasant. They’re often described as a sort of fluttering feeling in the chest, or sometimes it can feel like your heart is racing or pounding like it never has previously. Sometimes it can feel like your heart is skipping a beat, or on the other side, like your heart is getting extra beats, or jumping about. The sensation can last for a matter of seconds to minutes, hours, or even days,” Bernadette explained.

What causes palpitations and are they always a cause for concern?

Bernadette explained that in many cases the cause of the palpitation is not known however, she said that certain situations and lifestyle factors can trigger palpitations causing them to occur more frequently.

Some of the more common triggers include:

• Strenuous exercise
• Surges of adrenalin, a hormone released in response to strong emotions like anxiety, excitement and stress
• Cigarette smoking due to the stimulating effect of nicotine
• Excessive consumption of tea or coffee due to the stimulating effect of caffeine
• Drinking excessive amounts of alcohol or eating rich, spicy foods
• Using recreational drugs
• Illness such as colds or flu and fever

Less common triggers:
• Hormone changes associated with menstruation, pregnancy or menopause
• Side effects from some types of medication e.g. some asthma inhaler medications that contain stimulants; some cold and cough remedies.

Palpitations can sometimes be associated with other medical conditions which can make the heart beat faster, stronger or irregularly. These include an overactive thyroid; a low blood sugar level; anaemia (a low blood count); an abnormal heart rhythm (arrhythmia).

When do I need to contact my doctor?

As mentioned earlier, palpitations are a common occurrence and are usually nothing to worry about. However, Bernadette advised that if you have a history of heart disease or your palpitations become more frequent or worsen, and are accompanied by other symptoms, such as dizziness, fainting or tightness in your chest, this can sometimes be a sign of a heart problem and may need further investigation.

What treatments are available?
In most cases no treatment is required other than to avoid potential triggers, as described above, Bernadette said.

“Alternatively, your doctor may recommend medicine to stop, prevent or control the palpitations,” she added.

If you have a history of heart disease, or your palpitations have become more frequent, worsened, and are accompanied by other symptoms, you may have a heart rhythm problem (arrhythmia), such as atrial fibrillation (A Fib) or supraventricular tachycardia (SVT).

In some of those cases, you may need a heart procedure such as cardioversion or ablation to treat the abnormal rhythm. Some people may require a pacemaker or implantable cardioverter defibrillator (ICD).