Heart palpitations feel like your heart is going through a pounding, rapid beating, or racing rhythm. One can feel them in the neck, throat, or chest. It is often caused by excess stress, prescription treatments, or an underlying health condition. In most cases, such palpitations are known to be harmless. In a few others, however, they might be a symptom of a critical condition like arrhythmia and may require immediate attention.

Symptoms
Heart palpitations may feel as though the heart is pounding, fluttering, flip-flopping, missing a beat, racing, or having an extra beat. The symptoms are predominantly associated with an abnormal heart rhythm if one has an abnormal heart valve, risk factors for heart disease, or heart disease. The palpitations usually do not last long and stop in a few minutes or seconds. But in some instances, they may last longer. When they are not worrisome, they may not cause any additional symptoms. But in rare cases, they may come with signs like fainting, chest pain, breathlessness, and dizziness. All of these symptoms together indicate an underlying heart condition.

Causes
There can be several causes of heart palpitations. They may be either associated with the heart or originate due to external reasons. Some of these include:

• Strong emotions like stress, fear, or anxiety, where palpitations occur during panic attacks.
• Extreme physical activity
• Conditions like low blood sugar, thyroid disease, dehydration, fever, low blood pressure, and anemia.
• Some nutritional or herbal supplements
• Taking decongestants, and using asthma inhalers or prescription treatment for arrhythmias or underactive thyroid
• Abnormal electrolyte levels
• Hormonal changes during pregnancy, menstruation, or before menopause
• Excessive caffeine intake.

Some people experience heart palpitations after eating meals rich in sugar or carbohydrates. Eating foods with a lot of nitrates, monosodium glutamate, and sodium can also lead to palpitations. If eating certain foods causes palpitations, it is possible that the person has a food sensitivity. In this instance, one can consider maintaining a diary to figure out which foods must be avoided.

At times, heart diseases, like arrhythmia, may also be the cause of palpitations. Other heart conditions related to palpitations are heart failure, heart muscle problems, heart valve issues, coronary artery disease, and previous heart attack.

Diagnosis
The healthcare provider will first perform a physical examination and try listening to your heart with a stethoscope. They will look for conditions that may cause palpitations, such as swollen thyroid glands. They may also inquire about your health history. However, if the doctor feels heart conditions or an irregular heartbeat is causing the palpitations, they will order tests like:

• Holter monitoring: You wear a portable Holter monitor, a type of ECG device, for a day or two to record the heart’s rhythm and rate during routine activities.
• Electrocardiograms (ECG): They are painless and quick tests to assess the heart’s electrical activity. An ECG device can detect if the heart is beating too slowly.
• Echocardiogram: It is a noninvasive test that employs sound waves to produce pictures of the heart in motion. It detects any problems with the heart’s structure and blood flow.
• Event monitoring: Doctors may advise this if you do not have an irregular heart rhythm while wearing a Holter monitor or if such events occur less than once weekly.

Treatment
The treatment will depend on the reason for the palpitations, as the doctor needs to address the probable underlying conditions. In certain cases, the doctors might not be able to find the cause. Heart palpitations do not necessarily require treatment unless the doctors find an underlying condition that’s responsible for it. But if the palpitations do not have a medical reason, one can manage the symptoms by:

Keeping a check on what you eat
Low blood sugar amplifies the risk of heart palpitation. So, reducing simple carbs and sugar with complex carbs can help keep blood sugar levels in check. Consider replacing baked goods, sugary sodas, and fruit juice concentrates with fresh fruits, vegetables, and whole grains.

Managing anxiety and stress
Try relaxation techniques to reduce palpitations due to anxiety or stress. Some popular options include tai chi, breathing exercises, physical activity, biofeedback, meditation, and yoga.

Altering ongoing treatments
If one’s prescription options are responsible for palpitations, they can request the doctor for alternatives.

Avoiding stimulants
One should minimize or avoid caffeine, as it may lead to palpitations.