Cardiac Center

Heart Palpitations (Irregular Heartbeats and Skipped Heartbeats)

Before you begin reading about heart palpitations, please read the explanation of how the normal heart works for a basic understanding of its structure and function.

What is a heart palpitation?

A heart palpitation occurs when a person feels that his or her heart is beating irregularly. It might feel like the heart is skipping beats, or is beating faster than usual when the person is at rest (not exercising).  Sometimes exercise can cause the palpitations to occur, with the heart continuing to race despite stopping exercise.

Heart palpitations often don't indicate a health problem. They can be caused by a variety of factors, including: being startled, frightened or under stress. Cold, allergy, and asthma medications; herbal supplements; cocaine, and other drugs; pregnancy or menopause; and nicotine, caffeine and alcohol can also cause heart palpitations. Two of the most frequent causes for heart palpitations are just not drinking enough fluid on a regular basis, or being deconditioned (out of good physical shape).

Younger children may not be able to describe exactly what they are feeling when this happens, although sometimes they will say that their heart is "beeping" fast.

Rarely, heart palpitations can be a sign of a serious medical condition, such as anemia, thyroid problems or an arrhythmia. (An arrhythmia is an irregular heartbeat caused by a problem with the heart's built-in electrical system.)


What should I do if my child has a heart palpitation?

If your child experiences any of the following along with heart palpitations, you should make an appointment with your primary care pediatrician right away.

If your child experiences heart palpitations without any of the above, you should keep a log of when palpitations occur and under what conditions, and talk to your primary care pediatrician at a regular checkup. If the palpitations occur often, and you are concerned, call your doctor or make an appointment to discuss the issue. If you are able to check your child’s heart rate by taking the pulse or touching the chest directly when the palpitations occur, that information will be helpful to your doctor. Ask your pediatrician for information on how to check your child's heart rate.

Make sure to tell your doctor if your family has a history of known heart abnormalities or unexplained death before the age of 50 (including sudden infant death syndrome).


How can a doctor tell if heart palpitations are cause for concern?

Your primary care doctor will consider factors such as the frequency and intensity of the heart palpitations and your child's medical history. In the majority of cases, no treatment is necessary for heart palpitations. Your doctor may make general recommendations, such as cutting back on caffeinated soda or increasing routine hydration.

Or, you may be given a referral to a pediatric cardiologist, a doctor who specializes in heart problems in children. He or she will perform a full evaluation of your child's health, including getting a medical history and performing an examination, as well as possibly ordering heart tests such as an electrocardiogram, echocardiogram, stress test (on a bicycle or treadmill) or, rarely, cardiac catheterization. Your child may have to wear a Holter monitor, which records the heart rhythm over 24 hours. Another type of monitor that your doctor may have your child wear is a loop recorder, which is worn for one month but records only when the child pushes a button on the recorder at the time of an event of palpitations. If you have the results of these tests already, don't forget to bring them to your doctor's visit.

Based on the results of these tests, the pediatric cardiologist will determine whether your child has an arrhythmia, which is an irregular heartbeat caused by a problem with the heart's built-in electrical system.


What are the treatment options for heart palpitations?

In rare cases where we do find an underlying heart condition, one treatment option includes medications. Another option is ablation, a catheterization technique using heat or cold to sear off abnormal electrical passageways in the heart. Rarely, children with heart palpitations will need implantable pacemakers or defibrillators.

However, only a very small number of children with heart palpitations require these types of treatment, and the large majority of these children do very well with their treatment.


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Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.

Reviewed by: William Bonney, MD
Date: September 2013

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