Exercising With Heart Flutters: Is It Dangerous?

Photo credit: Todor Tsvetkov/iStock

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. 

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 Institute here.