Heart pounding includes a constellation of symptoms described as racing, fluttering, or skipping, also referred to as palpitations. This sensation is familiar and often a benign physiologic response to caffeine, energy drinks, and some medications. Additionally, some medical conditions can produce palpitations, such as low blood sugar, thyroid disease, and anemia. Palpitations can occur at any time of day and resolve spontaneously without treatment. Other times, however, palpitations can be more ominous, and recognizing the warning signs when a more serious cause is to blame is critically important. Here are 4 signs that require an immediate evaluation by a healthcare professional.

1. Chest pain or discomfort

Sudden onset of chest pain, especially a squeezing sensation, is indicative of a heart attack, often leading to sweating and pain radiating to the jaw or arm. Palpitations may accompany the pain, as well as shortness of breath. A heart attack occurs when a blood vessel or coronary artery supplying oxygenated blood to the heart muscle is blocked or narrowed, causing ischemia. Emergent evaluation is paramount in protecting heart function and preventing further heart damage. Interventions, including minimally invasive coronary angioplasty performed by a heart specialist, can often open the artery and restore blood flow if evaluated early enough.

2. Fainting or dizziness

When experiencing a rapid heart rate accompanied by dizziness or fainting, seek immediate medical attention. These symptoms could indicate an underlying heart issue, such as an arrhythmia, which disrupts the rhythm of the heart and can lead to insufficient blood flow to the brain. Prompt medical evaluation is essential to diagnose the cause and initiate appropriate treatment, preventing potential complications.

3. Finding it difficult to breathe

Shortness of breath (SOB), which is sudden in onset and unexplained, particularly when accompanied by heart pounding or chest pounding, indicates an imminent need for medical attention. SOB is associated with many medical conditions, including arrhythmias, heart attacks, lung infections, and pulmonary embolism (PE). The lungs are responsible for oxygenating the blood during the act of breathing. An embolism is a blockage in one or more of the arteries of the lung by a blood clot or air bubble. A PE can cause abrupt shortness of breath, rapid heart rate, and poor oxygenation. Emergency management might include oxygen supplementation and blood thinning medications to dissolve the clot.

4. Altered mental status

Any combination of the above conditions can lead to confusion and altered mental status by disrupting the flow of blood to the brain. As the brain is depleted of oxygen, confusion, dizziness, and lightheadedness can develop. Any unexpected confusion should not be ignored, and immediate medical attention should be sought. Even subtle changes like difficulty concentrating, forgetfulness, or unusual behavior can be warning signs. Early intervention is the critical step to a healthful outcome.

Don’t ignore a pounding heart

A pounding heart can be a harbinger of a more insidious underlying medical emergency. Coinciding signs, such as chest pain, rapid heartbeat, and shortness of breath, indicate a need to seek medical attention as these symptoms often follow serious medical conditions like heart attack and pulmonary embolism. Changes in mentation, confusion, and even subtle shifts in behavior can signal a disruption in blood flow to the brain, warranting medical attention. Medical emergencies promptly treated offer the most desirable outcomes.