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If your heart feels like it’s doing something out of the ordinary, you might find yourself frantically Googling to figure out what’s going on. Chances are, you’re experiencing what’s commonly known as “heart palpitations,” which is a catchall term for feeling like your heart is acting weird. Seriously.
Your heart beats because it has the very important job of sending oxygen-rich blood and nutrients to every part of your body. It also sends the carbon dioxide your body produces as a waste product to your lungs so you can expel it. When there’s a glitch in this system, you might experience a palpitation. Heart palpitations may feel like your heart is beating too quickly, beating irregularly, fluttering in a strange way, or thumping hard in your chest, according to the Mayo Clinic.
“Generally when we talk about palpitations, it means you’re aware of your heart beating, and it feels like it’s not normal,” Shephal Doshi, M.D., director of cardiac electrophysiology at Providence Saint John’s Health Center in Santa Monica, Calif., says.
If you ask four people with heart palpitations to describe them, you might get four varying answers. “When people say, ‘I have heart palpitations,’ they can mean so many different things that you have to tease out some details as to what exactly they feel,” Sanjiv Patel, M.D., cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif., tells us. Which is all to say that the symptoms of heart palpitations aren’t cut and dry.
When to worry about heart palpitations depends on a few factors. In reality, heart palpitations usually aren’t a sign your heart’s decided to give up the ghost—but in some cases, they can be a cause for concern. Here’s how to tell the difference.
Here are some common reasons your heartbeat might seem off.
“Most of the time when people feel palpitations, their heart is not doing anything bad,” Dr. Doshi says. There are tons of reasons your heart can go a little wonky, and most of them are nothing to worry about.
Typically, your heart knows when to squeeze based on electrical impulses from a group of cells known as your sinoatrial (SA) node, according to the National Heart, Lung, and Blood Institute (NHLBI). These cells are housed in your heart’s right chamber, also known as its right atrium. If your SA node starts sending wonky electrical impulses, you might experience heart palpitations.
Anything that increases the adrenaline in your body can affect these electrical impulses, Dr. Doshi says. That includes stress, panic attacks, caffeine, having a cold or flu, being sleep-deprived, and taking medications that contain stimulants. Your heart has receptors that pick up on heightened adrenaline, so any surges of this hormone can cause it to act differently.
Things that make your heart work harder can also cause palpitations, Dr. Doshi says. That’s why experiencing palpitations during or after a tough workout isn’t immediately a reason to worry. Same goes for having them during pregnancy, when your blood volume goes up and your heart has to pump out that extra fluid.
There’s also a chance you might think you have heart palpitations, but actually don’t. “Some people are very attuned to their bodies, feel their hearts beating faster and think it’s a palpitation, but it’s still beating at a normal speed of up to 100 beats a minute,” Dr. Patel says.
Sometimes, though, palpitations might signal something more serious.
For example, these impulses go offbeat due to arrhythmias, which are basically short circuits in your heart’s electrical system. Arrhythmias can make your heart beat irregularly and feel strange, along with weakness, dizziness, feeling light-headed, fainting, shortness of breath, and chest pain, among others.
While arrhythmias often aren’t dangerous and can be treated in many ways, sometimes they can be life-threatening. Only a doctor can tell you for sure, but any symptoms besides the strange heart sensations are typically a clue that your arrhythmia may be more serious, says the NHLBI. If you think you’re experiencing any strange symptoms along with your heart palpitations, seek medical attention immediately.
Other times, heart palpitations can be a sign that something’s up with a different organ, like your thyroid gland. Your thyroid produces hormones like thyroxine and triiodothyronine, which influence many of your body’s systems, according to the Mayo Clinic. If your thyroid is on overdrive (aka, you have hyperthyroidism), it will generate too much thyroxine, which kicks up your body’s metabolism. This can lead to a rapid or irregular heartbeat, along with symptoms like an increased appetite and sudden weight loss.
You may also experience heart palpitations if you have a physical abnormality like a weaker or larger heart than usual, which you typically wouldn’t know about unless it showed up during some kind of medical exam.
All told, here’s when you should go see your doctor.
You may be wondering when to worry about heart palpitations, especially when most of the time, they’re NBD. One-off heart palpitations that just last a few seconds are a normal part of having a heart. That said, experiencing them regularly is not. “If heart palpitations happen every time you do [a certain activity], like walk half a mile or lift something, that’s not a random event and you should be evaluated,” Dr. Patel says.
If your heart palpitations come along with any symptoms like dizziness, feeling unsteady, fainting, or chest discomfort or pain, that’s a sign your heart’s functioning may be compromised. “That warrants further investigating to make sure it’s nothing dangerous,” Dr. Doshi says.
Your medical history also comes into play, especially if you have a history of health conditions involving your heart. According to Dr. Doshi, a healthy 30-year-old has less reason for concern than a 60-year-old with heart disease (the most common cause of heart failure).
With that said, if your heart palpitations are random, don’t come with other symptoms, and you’re in great health, they might still feel too weird to ignore. There’s no law against seeing your doctor just to be on the safe side. They can test your heart to make sure it’s working as it should so you can skip worrying about your health the next time your heart skips a beat.
