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Heart Palpitations

  • What to Know About Thumps, Flutters and Skipped Beats

  • When it comes to heart palpitations, the increased awareness around heart attack symptoms has been a double-edged sword. On one hand, growing knowledge about heart disease has made us savvier about our bodily symptoms. But at the same time that awareness causes us to worry when we feel a racing heart, rapid pulse or our heart skipping a beat. How serious is it?

    MyLifeStages talked with San Francisco Internal Medicine Doctor Toni Brayer, M.D., about the different sensations that bring patients to her office – or the Emergency Room. She helped us sort them out.

    “Patients often become aware of their heart beat and wonder if it’s normal,” says Dr. Brayer. “Particularly during menopause, women may feel more random, irregular heartbeats, or the sensation of the heart skipping a beat.”

    You should never ignore potential heart attack symptoms. The signs of a heart attack in women may be different than in men. But the occasional thump, skipped beat, or a racing heart can make us worry, often unnecessarily. What should we do? Heart palpitations are common and often harmless. (See Should I be worried about my heart palpitations?)

    “The most important thing I tell patients is to sit down, relax , and then take your pulse,” says Dr. Brayer. “Count the beats of your heart for 15 seconds and multiply by four to get your heart rate. If it’s under 100 beats per minute, and you are feeling okay, you are probably not experiencing a serious rhythm disturbance.”

    Exercise, of course, will raise your heart rate above 100, and that’s good (as long as you don’t exceed your target heart rate). But a resting pulse that suddenly rises to 100 beat per minute or more can be a sign of tachycardia – a more serious disturbance in the rhythm of the heart.

    If you are feeling irregular beats or a racing heart, and feel light-headed, dizzy or otherwise “wrong,” then you should call your doctor right away, or head to the Emergency Room.

    What Causes Heart Palpitations?

    Irregular beats can have many causes, so if you have the experience on and off, talk with your doctor. Medications, fluctuations in hormonal levels, and stress are just a few things that can cause these sensations – without evidence of any underlying heart disease. A few simple tests in the doctor’s office can rule out major issues for most.

    Dr. Brayer notes that these skipped beats often happen irregularly. You might have a spell at home, but when you arrive at the doctor’s office, your heart is beating regularly. One method of diagnosing a recurring sensation is a Holter monitor. This device is worn by the patient for 24 hours, and it records the electrical activity of the heart. Combined with a journal kept by the patient, the doctor can then discern whether what you are feeling matches a true irregularity in your heart.

    If you are concerned with your palpitations, don’t wait around. See your doctor, who can sort out whether you have an underlying heart condition, or can reassure you of the cause of your flutters – and help you manage the symptoms. The visit will be a wise investment in your peace of mind.