HEART PALPITATIONS

Question: Every so often I notice my heart beating fast. By the time I notice it and check my pulse, it has already slowed down. I feel fine when this is happening, which is usually in the evening when I am reading. I am pretty healthy otherwise, but I don’t get much exercise. Do I need to exercise more?

Answer: The heart normally speeds up and slows down in response to activity, but to have your heart race while you are at rest is a potential red flag that warrants some investigation.
A fast heartbeat that comes and goes is called a palpitation. There are many things that cause palpitations. Some are fairly benign; others require medical attention. Because an intermittent rapid heartbeat will probably not be present when you go to the doctor’s office, you will be asked many questions that will help her or him zero in on the cause.
Here are some questions your physician is likely to ask (knowing these questions in advance can help you be prepared for your appointment): How long did your longest episode last? Do you notice other symptoms, like lightheadedness or dizziness, when the racing occurs? Is the rapid heartbeat associated with skipped beats? Continue trying to check your pulse during one of these episodes to help determine if your heart may be skipping beats. If you do notice skipping, be sure to report this to your physician even if she or he does not ask.

Palpitations are very common, and most of the time they are not caused by heart trouble. Palpitations can be caused by stress; strenuous activity; medications like sinus pills, caffeine, alcohol and nicotine; or diseases like thyroid trouble, anemia and heart disease. Many people who notice palpitations also drink more coffee or tea than they realize.

Your question about exercise is very relevant. People who do not get enough exercise are, in fact, prone to having a faster resting heartbeat. Some consequences of lack of exercise – for example, obesity – can also contribute to palpitations. But before you start an exercise program, you should consult your physician. Keep a log of when the palpitations occur, including how many times a day or night they come on and what you were doing immediately before you noticed them. Keep track of how much caffeine you are consuming, and check the labels on all over-the-counter medications you take. To make sure your medications won’t cause or complicate heart palpitations, check with your family doctor or pharmacist.

When you talk to your doctor, she or he may want to do blood tests, as well as have you wear a device called a Holter monitor. This device takes an electrocardiogram; it traces your heartbeats for 24 to 48 hours. This painless test can help your doctor determine if your palpitations need further medical intervention, lifestyle modifications or both.