What is it called when someone occasionally feels their heart racing?
The sensation of feeling your heart racing is called "palpitations"—defined as heartbeat sensations that feel like pounding, racing, an unpleasant awareness of heartbeat, or feeling skipped beats or a pause, typically felt in the chest, throat, or neck 1.
Clinical Definition
Palpitations are characterized by:
- Heartbeat sensations that feel like pounding or racing
- An unpleasant awareness of heartbeat
- Feeling skipped beats or a pause
- Typically localized to the precordium (chest), neck, or throat 1
The term encompasses both regular and irregular heartbeat sensations 2.
What This Symptom Represents
Palpitations are among the most common cardiovascular symptoms, accounting for 16% of all primary care visits and representing the second leading cause of referral to cardiologists 2. While the sensation itself is simply an awareness of the heartbeat, the underlying causes range from completely benign to potentially serious cardiac arrhythmias.
Key Clinical Distinctions
The pattern and characteristics matter significantly:
- Regular, paroxysmal palpitations with sudden onset and termination most commonly result from supraventricular tachycardias like AVRT or AVNRT 3
- Irregular palpitations may indicate premature depolarizations, atrial fibrillation, or multifocal atrial tachycardia 3
- Gradual onset and termination suggests sinus tachycardia rather than a paroxysmal arrhythmia 3
When Palpitations Signal Concern
Palpitations should be considered potentially more serious when associated with:
- Dizziness or lightheadedness
- Near-syncope (feeling faint, "graying out") or actual syncope (loss of consciousness)
- Chest discomfort or dyspnea
- Occurrence during exercise or physical exertion 1, 4, 5
Important Caveat
Most palpitations are benign—studies show that in patients without cardiac arrhythmias on monitoring, up to 29% have psychiatric disorders (particularly panic disorder or major depression) as the underlying cause 6. However, any palpitations warrant at minimum a 12-lead ECG to exclude dangerous rhythms 2, 5.
Clinical Classification
According to ACC/AHA/ESC guidelines, palpitations fall under "minimal symptoms" in the hemodynamically stable category of arrhythmia presentations, distinguishing them from more serious presentations like presyncope or syncope 1.
The sensation itself is a symptom, not a diagnosis—the actual rhythm disturbance (if present) requires ECG documentation for definitive identification 7, 8.