A sudden flutter in your chest can be unsettling. You might notice your heart racing while sitting at your desk, skipping a beat after drinking coffee, or pounding unexpectedly when you are trying to sleep. But do heart palpitations mean you are at risk of a heart attack or sudden cardiac arrest?
Key Takeaways
- Heart palpitations describe the sensation of your heartbeat, not a diagnosis.
- Most palpitations do not directly cause a heart attack, but certain abnormal heart rhythms can increase the risk of serious complications.
- Heart attacks and sudden cardiac arrest are different medical emergencies, although one can lead to the other.
- Chest pain, severe breathlessness, fainting or collapse alongside palpitations requires urgent medical attention.
- Recurrent palpitations deserve assessment, particularly if you have an existing heart condition.
What Is the Difference Between Palpitations, a Heart Attack and Cardiac Arrest?
These three terms are often confused, but they describe different things.
Heart palpitations are sensations that make you unusually aware of your heartbeat. Your heart might feel as though it is racing, pounding, fluttering or missing beats. They can occur with a normal heart rhythm or an abnormal one.
A heart attack happens when blood flow to part of the heart muscle is significantly reduced or blocked, potentially damaging the muscle. Symptoms can include chest pressure, discomfort spreading to the arm or jaw, breathlessness, sweating and nausea.
Sudden cardiac arrest occurs when the heart abruptly stops pumping blood effectively, usually because of a dangerous electrical rhythm disturbance. The person may collapse, lose consciousness and stop breathing normally.
A heart attack can trigger cardiac arrest, but they are not interchangeable conditions. Palpitations alone do not establish that either is happening.
When Can Heart Palpitations Signal Something More Serious?
Occasional palpitations may occur because of stress, anxiety, caffeine, alcohol, dehydration or certain medicines. They can also accompany fever, anaemia or an overactive thyroid.
However, palpitations can sometimes indicate an arrhythmia, which is an abnormal heart rhythm. Examples include atrial fibrillation, where the upper chambers of the heart beat irregularly, and certain rapid heart rhythms that originate in the heart’s lower chambers.
Some arrhythmias are relatively manageable, while others can affect the heart’s ability to pump blood and, in particular circumstances, lead to serious complications.
The risk depends on several factors,
- The type of rhythm disturbance- Different arrhythmias carry different risks.
- Existing heart conditions- Previous heart attacks, heart muscle disease or structural heart problems may increase concern.
- Associated symptoms- Dizziness, fainting, chest discomfort or breathlessness can indicate a more significant problem.
- The pattern of episodes- Palpitations that begin during physical exertion, occur repeatedly or last longer than usual may warrant investigation.
The sensation alone cannot reliably tell you whether an abnormal rhythm is harmless or dangerous.
Which Symptoms Mean You Need Urgent Medical Attention?
Do not assume that palpitations are harmless simply because they have happened before. It is advisable to call 995 for an ambulance in Singapore if palpitations occur with symptoms suggesting a medical emergency, including,
- Chest pain, pressure or tightness.
- Severe difficulty breathing.
- Fainting or sudden collapse.
- Marked dizziness accompanied by feeling seriously unwell.
Even if the episode settles, seek prompt medical assessment if you experience recurrent palpitations, unexplained dizziness or episodes during exercise.
How Can a Cardiologist Determine the Cause?
A heart palpitations cardiologist will consider more than how fast your heart feels. The aim is to identify the rhythm involved and determine whether an underlying condition needs attention.
Depending on your symptoms and medical history, assessment may include,
- Medical history and examination- Reviewing when the palpitations occur, how long they last, your medications and any associated symptoms.
- Electrocardiogram- Recording the heart’s electrical activity. An ECG may identify an abnormal rhythm if it occurs during the recording.
- Ambulatory heart monitoring- A Holter monitor or another wearable device may record your rhythm over a longer period if episodes are intermittent.
- Blood tests or further investigations- These may be considered to check for contributing conditions or assess possible underlying heart disease.
Not everyone needs every test. The appropriate investigations depend on the clinical findings.
Frequently Asked Questions
1. Can anxiety-related palpitations cause a heart attack?
Anxiety can trigger palpitations without an underlying dangerous rhythm disorder. However, anxiety does not rule out a heart problem. New or concerning symptoms should be assessed rather than automatically attributed to stress.
2. Can heart palpitations lead to sudden cardiac arrest?
Most palpitations do not lead to cardiac arrest. However, palpitations caused by certain dangerous arrhythmias may indicate an increased risk, particularly in people with underlying heart disease.
3. Can I have palpitations without knowing I have a heart condition?
Yes. Palpitations can occur in people without diagnosed heart disease. They can also be an early indication of an underlying condition, so recurrent or unexplained episodes may need investigation.
4. Should I see a cardiologist if my palpitations stop on their own?
Consider medical assessment if the episodes recur, are unexplained or occur with dizziness or other concerning symptoms. An ECG or longer-term heart monitoring may help identify an intermittent rhythm disturbance.
5. Can an ECG detect the cause of every palpitation?
No. An ECG records the heart’s electrical activity at a particular time. If your palpitations are intermittent, the rhythm may be normal during the test. Longer-term monitoring may be appropriate.
Schedule a Cardiology Consultation to Know Your Heart Health
Heart palpitations do not automatically mean you are having a heart attack or are at risk of sudden cardiac arrest. However, recurring episodes should not be dismissed, especially when accompanied by other symptoms or an existing heart condition.
If you are concerned about your symptoms, consider arranging a consultation with Dr. Yong Thon Hon at Forte Cardiology Clinic to discuss your medical history and whether further assessment is appropriate. Understanding the cause can help guide decisions about monitoring, investigations and any treatment that may be needed.
