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Are Heart Palpitations Normal?

Updated: Nov 12, 2023

Many of you are wondering: Are heart palpitations normal?


That's a great question.


There are various causes of heart palpitations, which can be a feeling of fast heartbeats, irregular heartbeats, or missed or skipped heartbeats, for example.



PREMATURE (EARLY) BEATS CAN FEEL LIKE IRREGULAR, MISSED, OR SKIPPED BEATS


Many people have extra heartbeats starting from the top or bottom of the heart, that are usually rare and don't usually cause any problems. Extra heartbeats starting from the top of the heart are called "premature atrial complexes" or "premature atrial contractions". Extra heartbeats starting from the bottom of the heart are called "premature ventricular complexes" or "premature ventricular contractions". These extra beats tend to occur earlier than normal, compared to your other heartbeats. Because of this, the heart takes some to recover from the early/premature/extra beat, and the next/subsequent/following heartbeat is therefore delayed. This is why some people experience this phenomenon as "missed" or "skipped" beats - because of the heart recovering after an early/premature beat. Counterintuitive, we know. The heart is full of wonders. Because so many people have these and they don't usually cause problems, a tiny amount of these happening can be thought of as being "within normal limits".

SUPRAVENTRICULAR TACHYCARDIA


Fast heartbeats can sometimes be due to supraventricular tachycardia, which is a fast regular/periodic heartbeat originating from the top of the heart. This is not a normal heart rhythm, but most of the time it does not cause any problems. Sometimes this heart rhythm can last for some time and indeed cause problems and need intervention.


VENTRICULAR TACHYCARDIA


Fast heartbeats can sometimes be due to ventricular tachycardia, which is a fast regular/periodic heartbeat originating from the bottom of the heart. This is not a normal heart rhythm, and can raise our eyebrows when we see it. When we see ventricular tachycardia, we want to check to make sure your electrolytes (like potassium, calcium, and magnesium) are at normal levels. The heart sometimes does not tolerate abnormal electrolyte levels, as the electrical activity of the heart depends on normal levels of these electrolytes in your body. Sometimes ventricular tachycardia can be caused by limited blood flow to your heart, which can be due to blockages in the blood vessels that bring blood and oxygen to your heart. A stress test can be helpful to look for this. A stress test typically involves physically stressing your heart with exercise (such as having you walk and run on a treadmill) or with medication, in a controlled setting in a heart clinic or in the hospital. Sometimes ventricular tachycardia lasts for a short while. Sometimes this heart rhythm can last for some time and indeed cause problems and need intervention. The heart may not be able to effectively pump blood to the rest of your body when the heart is experiencing ventricular tachycardia.


ATRIAL FIBRILLATION


Sometimes heart palpitations are caused by "atrial fibrillation", which we cover in a different blog article. Look out for it!


PALPITATIONS

Various heart rhythms (normal or abnormal) can cause heart palpitations. Some people call heart palpitations "flutters" or "fluttering". Some people feel the various normal or abnormal heart rhythms, and some people don't.


HEART MONITOR


A heart monitor can be helpful to identify the heart rhythms causing the heart palpitations, so that we can know whether the heart rhythms are normal or abnormal, and suggest appropriate care. A heart monitor can be a patch on the chest over the heart that monitors the heart rate and heart rhythm continuously for a defined period of time, such as two weeks. When you wear a heart monitor, be sure to write down what you feel (such as heart palpitations) and the day and time, so that when you hand everything back, we can see if there is an observed correlation between what you wrote down, indicated, or triggered on the device, versus what we see on the ECG strips from the monitor. To see if we can determine which heart rhythm(s) may be associating with your heart palpitations.


SO, ARE HEART PALPITATIONS NORMAL?


Some are and some are not. It depends on the heart rhythm(s) causing the palpitations. A heart monitor can be helpful to help us sort this out, and to help us help you receive the best and safest care.


Reach out to your primary care provider and/or cardiologist today to learn more about heart palpitations and make sure yours is under control and managed well, even if it may not be officially formally "reversed", depending on your definition.


We are always also here to help at My Heart Risk in Cancer. Reach out today.

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