When should I worry about palpitations?

Palpitations, racing heart, palpitations (once or rarely)

At rest, the heart has a frequency of 50–90 beats per minute. The heartbeat is clocked by the sinus node, a collection of specialized cells in the wall of the right atrium. It generates electrical impulses that spread to the whole heart via the conduction system and cause the heart muscles to contract. Although the sinus node functions independently, it is subject to the influence of nerves and hormones. They adjust the heart rate to different conditions, e.g. B. the time of day or physical activity. For example, the heart rate rises to over 200 beats per minute in young people during intense physical activity. An increase in heart rate when Palpitations or Racing heart perceived, is temporarily part of the reaction to physical exertion and stress stimuli. If the heart rate is permanently increased, this indicates a cardiac arrhythmia or a panic attack, as well as a side effect of circulatory collapse, shock and various organ diseases.

Electrical impulses can also arise outside the sinus node in other parts of the conduction system and in "normal" heart cells. They often lead to extra beats, called extrasystoles, which are known as Palpitations or make dropouts noticeable. If extrasystoles occur only occasionally and without any further symptoms, they are usually harmless. In connection with symptoms such as shortness of breath, headache or fever, however, they also indicate serious illnesses. Sometimes the normal rhythm is completely lost, resulting in an uneven pulse with pauses, fast and slow beats. This absolute arrhythmia is mostly due to organ diseases.

Symptoms, their causes, measures and self-help

  • Palpitations when you are excited, tired, in pain, fear or other strong emotions

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  • Palpitations and shortness of breath during unusual physical exertion without any further symptoms

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  • Occasional palpitations without further discomfort

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  • Seizure-like palpitations or racing heart that starts suddenly and usually ends abruptly; strong fear; possibly shortness of breath, chest pain or tightness; possibly tremors, sweats; possibly dizziness, nausea

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  • Sudden palpitation of the heart with dizziness, sweating and drowsiness; Ringing in the ears, turning black before the eye diseases; possibly short fainting

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  • Sudden onset of a completely irregular pulse rate; possibly tightness in the chest, fear; possibly shortness of breath

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  • Palpitations, racing or stumbling of the heart with a fever or after a febrile infection

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  • Sudden palpitations or racing of the heart in people with diabetes; Tremors, restlessness, sweating; Restlessness, confusion

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  • Sudden palpitations, racing or stumbling of the heart if you have known high blood pressure; often severe headache; often dizziness, nausea, sweating; possibly visual disturbances, confusion

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  • Sudden palpitations or racing of the heart with chest pain, shortness of breath and cough

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  • Fast and weak pulse with outbreak of cold sweat; pale gray skin, clammy hands; Tremors, restlessness, fear; may be confused or light-headed

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  • Palpitations, racing or stumbling after consuming or withdrawing from stimulants or drugs; often restlessness, trembling hands; possibly dizziness, nausea

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  • Palpitations, racing or stumbling of the heart after occasionally taking or stopping medication

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Palpitations when you are excited, tired, in pain, fear or other strong emotions

Root cause:

Self help:


Palpitations and shortness of breath during unusual physical exertion without any further symptoms

Root cause:

  • Normal reaction to inadequate training

Self help:

  • More exercise in everyday life (e.g. stairs instead of a lift), light endurance sports

Occasional palpitations without further discomfort

Root cause:

Measure:

  • In the next few days to the family doctor if the heart palpitations accumulate

Seizure-like palpitations or racing heart that starts suddenly and usually ends abruptly; strong fear; possibly shortness of breath, chest pain or tightness; possibly tremors, sweats; possibly dizziness, nausea

Causes:

  • Paroxysmal supraventricular tachycardias, e.g. B. WPW syndrome
  • Intermittent paroxysmal atrial fibrillation
  • Ventricular tachycardia, usually with known heart disease
  • Panic attack
  • Rare: pheochromocytoma

Activities:

  • Call an emergency doctor or go to the nearest clinic if this occurs for the first time, breathlessness, chest pain or clouded awareness
  • Otherwise to the family doctor on the same day

Self-help with WPW syndrome:

  • With your mouth closed and your nose covered, try to exhale (Valsalva maneuver)
  • Drink cold fizzy drink
  • Cool down the neck and face with cold water

Sudden palpitation of the heart with dizziness, sweating and drowsiness; Ringing in the ears, turning black before the eye diseases; possibly short fainting

Root cause:

  • Circulatory collapse, e.g. B. at

Measure:

  • See a doctor immediately after losing consciousness for the first time

Immediate action:

  • Immediately lie down flat, legs up, remove neck-tight clothing

Sudden onset of a completely irregular pulse rate; possibly tightness in the chest, fear; possibly shortness of breath

Root cause:

Absolute arrhythmia in atrial fibrillation, e.g. B. at

Activities:

  • Call an emergency doctor immediately if there is chest pain or shortness of breath
  • Otherwise, see a doctor on the same day if the pulse remains irregular

Palpitations, racing or stumbling of the heart with a fever or after a febrile infection

Causes:

Measure:

  • On the same day to the family doctor

Sudden palpitations or racing of the heart in people with diabetes; Tremors, restlessness, sweating; Restlessness, confusion

Root cause:

Measure:

  • Call an emergency doctor if you are unconscious or if self-help measures do not result in rapid improvement

Self help:

  • If possible, measure blood sugar
  • Immediately give fruit juice or soft drink to drink

Sudden palpitations, racing or stumbling of the heart with known high blood pressure; often severe headache; often dizziness, nausea, sweating; possibly visual disturbances, confusion

Causes:

Activities:

  • Call an emergency doctor if you experience any symptoms besides palpitations or stumbling of the heart
  • Otherwise, go to the family doctor on the same day if your own medication is not working sufficiently

Self help:

  • Measure blood pressure immediately
  • Then take emergency blood pressure lowering medication if on hand

Sudden palpitations or racing of the heart with chest pain, shortness of breath and cough

Causes:

Measure:


Fast and weak pulse with outbreak of cold sweat; pale gray skin, clammy hands; Tremors, restlessness, fear; may be confused or light-headed

Root cause:

Shock, e.g. B. at

  • Heart attack
  • extensive burns, severe blood loss, dehydration in the case of severe diarrhea
  • severe allergic reactions

Measure:

First measure:

  • Lay the affected person down flat, legs up
  • If you have had chest pain in the past, bring your upper body into a semi-sitting position

Palpitations, racing or stumbling of the heart after consuming or withdrawing from stimulants or drugs; often restlessness, trembling hands; possibly dizziness, nausea

Causes:

  • Excessive amounts of coffee, tea, alcohol, cola, cigarettes
  • Withdrawal from coffee or nicotine
  • Intoxication or withdrawal syndrome associated with alcohol dependence and drug addiction

Measure:

  • In the next few days to the family doctor if you fail to give up drugs

Palpitations, racing or stumbling of the heart after occasionally taking or stopping medication

Causes:

  • Side effect, e.g. B. of agents for low blood pressure, asthma drugs, agents for cold symptoms
  • Withdrawal symptoms, e.g. B. from beta blockers, sleeping pills, sedatives (tranquilizers)

Measure:

  • In the next few days to the family doctor if the symptoms do not improve after 2–3 days

Your pharmacy recommends

To get help.


If you have an acute, previously unexperienced, strong palpitations or palpitations, you should by no means lose time. In the case of a heart attack, just 15 minutes make the difference between life and death. Do not be afraid of a false alarm, but call the emergency doctor immediately if you or people around you are affected.

If heart palpitations occur even with slight exertion, this can of course be due to poor training condition. However, to increase stamina, you should take it step by step. You don't necessarily have to go to the gym for this, moderate jogging or brisk walks in the forest and park are also good workouts. If you have little time, it is often enough to cover everyday distances by bike or to use the stairs instead of the elevator.

Palpitations are a typical stress syndrome and often occur in psychologically stressful situations. Regardless of whether overstrain, fears or lack of time are the trigger - classic relaxation methods such as progressive muscle relaxation according to Jacobson, meditation and yoga have proven themselves in this case. If your palpitations occur in combination with strong fears, these can usually not be brought under control on their own. Here it is advisable to see a psychotherapist.

If you are a diabetic, you know that hypoglycaemia is associated with a racing heart. In order to quickly counteract this, it makes sense to always carry glucose with you. In this way, you can react immediately to acute hypoglycaemia - and also help strangers by simply shoving the glucose under the tongue of a diabetic who may be impaired. Alternatively, normal sugar cubes or sugary drinks such as fruit juices, Fanta or Cola also help.

The Valsalva maneuver helps to normalize the heartbeat again in acute palpitations: swallow and then try to exhale with your mouth closed and your nose held shut. This increases the pressure in the chest cavity, which means that less venous blood flows back into the heart chamber and the heart's action slows down.

Authors

Dr. med. Arne Schäffler; Dr. med. Brigitte Strasser-Vogel; in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Editing: Sara Steer | last changed on at 11:49 am


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.