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Heart palpitations: Cause for concern?

During a strenuous gym workout, your heart races. But it’s possible to experience pounding in your chest when sitting still, too. When you feel palpitations—abnormally hard, fast or fluttery heartbeats—pounding in your chest, should you be worried?

Fortunately, most palpitations aren’t dangerous. They can be caused by certain factors, such as:

  • drinking caffeinated beverages or smoking cigarettes
  • feeling anxiety or stress, or having a panic attack
  • exercising too vigorously
  • an overactive thyroid, or taking thyroid medication
  • mitral valve prolapse, a generally benign condition in which a heart valve doesn’t shut properly
  • anemia
  • fever

Palpitations also can be caused by an arrhythmia (irregular heartbeat)—which is a cause for concern, since it can lead to heart failure or a heart attack. If you have heart disease, a heart-valve abnormality or an increased risk for heart disease when your palpitations begin, you’re more likely to have an arrhythmia.

If you’ve never experienced palpitations, see your doctor to put your mind at ease. Keeping a diary of what you do before and during the palpitations may help him or her diagnose the cause more easily. Expect to have a full medical exam plus an electrocardiogram (EKG) during the appointment. Your doctor will want to know if you sweat, feel light-headed or experience shortness of breath when your heart races, because it could suggest arrhythmia.

There are several possible treatments for palpitations, depending on their cause. Your doctor may recommend that you:

  • Avoid caffeine and nicotine.
  • Practice stress-management techniques like yoga.
  • Exercise regularly without overdoing it.
  • Avoid medications that can cause palpitations, including some cold remedies.
  • Switch medications if a drug that you take regularly is found to be the source of the palpitations (such as some asthma treatments).