Lots of us experience heart flutters—it’s that brief flip-flop feeling we get in our chests. And most of the time, the sensation is fleeting and we forget about it almost immediately. However, when they occur while we’re exercising, they instantly become more disconcerting, and we’ve never been quite sure what to do when they happen. So, to find out why heart flutters occur during exercise, and what to do in response, we consulted Colleen M. Hanley, MD of Main Line Health’s Lankenau Heart Institute.

Dizziness and palpitations are two symptoms that are often related to each- other. Palpitation is the awareness of the heart beating, and dizziness is a term used to describe a range of sensations such as feeling faint, woozy, weak or unsteady, and vertigo (which is a false sense that you or your surroundings are moving). Occasional heart fluttering may be normal. However, if it recurs or persists, you should get an ECG done to rule out any cardiac arrhythmia (rhythm abnormalities. The main danger with atrial flutter is that your heart doesn’t pump blood very well when it beats too fast. Vital organs like the heart muscle and brain may not get enough blood, which can cause. Palpitations describe the sensation of feeling your own heart beating. They often feel like a fluttering, pounding, a thud or movement in your chest that might last for a few seconds or minutes. You may feel this in your neck, throat or through your ear when you’re lying down. Atrial flutter is an abnormality of the heart rhythm, resulting in a rapid and sometimes irregular heartbeat. Such abnormalities, whether in the rate or regularity of the heartbeat, are known as arrhythmias. The main danger of atrial flutter is that the heart does not pump blood well when it is beating too fast.

Are heart flutters during exercise cause for concern? Could it be dangerous?

Many people experience palpitations before and after exercise, but not during exercise. When most people start to exercise, their own heart rate increases and the palpitations, or extra beats, disappear at this higher heart rate. After exercise, the body’s adrenaline level remains high for a period of time while the heart rate decreases back to normal. Due to the higher adrenaline level in this time period, the palpitations can occur at an increased rate or frequency. As the adrenaline level decreases, the palpitations should decrease as well. If there are no associated symptoms, there is usually no cause for concern. If, however, palpitations occur during or following exercise and are accompanied by shortness of breath, chest discomfort, severe lightheadedness or loss of consciousness, further evaluation is necessary.

It almost feels like our heart stops when we experience a heart flutter. What is anatomically happening?

Heart flutters or palpitations are a perception of irregularity of the pulse, frequently described as a faster heartbeat than normal, a skipped beat, an extra beat, a flip-flop in the chest or a sensation that the “heart stopped.” The heart has a complex electrical system that stimulates it to beat. If the normal electrical pattern of the heart is disrupted a person may experience palpitations.

What causes heart flutters?

There are numerous causes for palpitations. Some common reasons a person may develop palpitations include:

-Stress, anxiety, fear, lack of sleep
-Dehydration
-Electrolyte abnormalities
-Caffeine, nicotine, alcohol, certain over the counter or prescribed medications
-Fever
-Overactive thyroid
-Anemia
-Low levels of oxygen in the body
-Hormone changes associated with pregnancy or menopause
-Diseases of the heart muscle, valves, coronary arteries or electrical system

Is there a way to stop them?

Depending on the type of heart flutter or palpitation, there are different treatment options. Often times, the most appropriate way to treat palpitations is to avoid triggers- i.e. reduce stress/anxiety, avoid stimulants, and lack of sleep.

If your palpitations are caused by an abnormal heart rhythm (arrhythmia), there are some maneuvers that you can perform at home that can stop the abnormal heart rhythm. These maneuvers include deep breathing, bearing down, or splashing cold water on your face.

If these techniques do not work, you may need a medication to treat your abnormal heart rhythm. Sometimes a medical procedure called a catheter ablation is necessary. In this procedure, radiofrequency energy is delivered to the abnormal electrical signals in the heart to destroy the targeted tissue and eliminate the abnormal heart rhythm.

Heart flutters seem particularly common in pregnant women. Is that true?

During pregnancy, most palpitations that occur are benign. In a normal pregnancy, the heart rate increases by 25% and some women may perceive this increase as fluttering. Additionally, in the pregnant state, there are significant shifts in blood volume. This increase in blood volume can put stress on the heart, which may then trigger palpitations. These fluctuations, as well as hormonal changes, can lend to physiologic changes that may render a pre-existing condition capable of sustaining an abnormal heart rhythm. If palpitations are experienced during pregnancy, you should bring it to the attention of your physician.

For more information about women’s heart disease and other cardiac health risks, visit Lankenau Heart Institutehere.

Heart palpitations are heartbeats that suddenly become more noticeable.

Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. You may also feel these sensations in your throat or neck.

Palpitations may seem alarming, but in most cases they're harmless and are not a sign of a serious problem.

Sometimes you may feel an extra or missed beat. These are known as ectopic beats and are also usually nothing to worry about.

Causes of heart palpitations

Causes of heart palpitations include:

• lifestyle triggers
• emotions and psychological triggers
• medicines
• hormone changes
• heart rhythm problems
• heart conditions
• other medical conditions

Lifestyle triggers

Common triggers of heart palpitations include:

• strenuous exercise
• drinks containing caffeine, such as coffee, tea and energy drinks
• illegal drugs, such as cocaine, heroin, amphetamines, ecstasy and cannabis
• rich or spicy foods

In these cases, the palpitations should go away on their own. Avoiding these triggers may help stop them from coming back.

Emotional or psychological triggers

Heart palpitations are also often caused by emotions or psychological issues, such as:

• excitement or nervousness
• stress or anxiety
• panic attacks – an overwhelming sense of anxiety or fear, accompanied by feeling sick, sweating, trembling and palpitations

Doing breathing exercises and learning how to deal with a panic attack may help if you're feeling stressed, anxious or panicked.

Medicines

My Heart Is Fluttering Meaning

Palpitations can occasionally be triggered by some medicines, including:

• asthma inhalers, such as salbutamol and ipratropium bromide
• high blood pressure (hypertension) medicines, such as hydralazine and minoxidil
• antihistamines, such as terfenadine
• antibiotics, such as clarithromycin and erythromycin
• antidepressants, such as citalopram and escitalopram
• antifungal medicines, such as itraconazole

Speak to a GP if you think a medicine may be causing your heart palpitations. But do not stop taking a prescribed treatment without first getting medical advice.

Hormone changes

Heart palpitations in women can sometimes be the result of hormonal changes that happen during:

• pregnancy
• the menopause

In these cases, the palpitations are usually temporary and not a cause for concern.

Heart rhythm problems

Palpitations are sometimes caused by a problem with the heart rhythm (arrhythmia), such as:

• atrial fibrillation – this is the most common type, where the heart beats irregularly and faster than normal
• atrial flutter – a fast and irregular heartbeat
• supraventricular tachycardia (SVT) – abnormally fast heart rate
• ventricular tachycardia – a more serious condition where the regular heartbeat is typically fast. It can be associated with dizziness or blackouts

Heart conditions

Some palpitations may be associated with other types of heart conditions, such as:

Chest Fluttering No Pain

• a problem with the heart valves, such as mitral valve prolapse
• hypertrophic cardiomyopathy – where the heart muscle and walls of the heart become enlarged and thickened
• heart failure – where the heart is unable to pump blood around the body properly
• congenital heart disease – birth defects that affect the normal workings of the heart

Some of these conditions can be serious and often require treatment.

Other medical conditions

Other conditions that can cause heart palpitations include:

• an overactive thyroid (hyperthyroidism) – where the thyroid gland produces too much of the thyroid hormones
• a low blood sugar level (hypoglycaemia) – this is most commonly associated with diabetes
• types of anaemia, which affects the red blood cells
• postural or orthostatic hypotension – dizziness and low blood pressure triggered by changing position (such as standing up)
• a high temperature

When to see a GP

You do not usually need to see a GP if the palpitations pass quickly and only happen occasionally. They're unlikely to be caused by a serious problem and probably will not need treatment.

But it's a good idea to see a GP if:

• the palpitations last a long time, do not improve or get worse
• you have a history of heart problems
• you're concerned about the palpitations

Occasional Heart Flutter

To help find the cause, a GP may:

• ask about your symptoms and medical history
• arrange a blood test
• carry out an electrocardiogram (ECG) to check your heart rate (if the GP has the equipment available)

If you cannot have an ECG at the GP surgery or the GP wants to arrange heart monitoring over a longer time period, you may be referred for tests at a local hospital.

When to get emergency help

Call 999 for an ambulance or go to your nearest A&E if you have heart palpitations and any of the following symptoms:

• severe shortness of breath
• chest pain or tightness
• dizziness or light-headedness
• fainting or blackouts

These symptoms could indicate a serious or potentially life-threatening heart problem that should be checked by a doctor straight away.

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Occasional Heart Fluttering Feeling

Page last reviewed: 24 October 2019
Next review due: 24 October 2022