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Should You Worry About Heart Palpitations When Exercising?

Heart palpitations when exercising, or right before or after exercise, usually occur because the normal electrical rhythm of the heart has been disrupted (by exercise). You may be especially susceptible to exercise-related heart palpitations if you smoke, have high blood pressure, or follow a poor diet. In very rare cases, heart palpitations after exercise could be a sign of atrial fibrillation, structural abnormalities, coronary artery disease (CAD), or myocarditis (inflammation of the heart).

If you experience heart palpitations together with chest discomfort, shortness of breath, severe lightheadedness, or fainting—or have palpitations and have had a heart attack in the past—seek urgent medical attention as it may be a sign of an impending heart attack or sudden cardiac arrest. Otherwise, it’s usually sufficient to make a note of your symptoms together with the activity, what you’ve eaten, and your mental and emotional state. If the symptoms continue, see a doctor for further evaluation.

Make Sure It’s Exercise-Induced Heart Palpitations and Not Just an Elevated Heart Rate from Exercise

During and after vigorous exercise, it’s normal for your heart rate to be elevated. According to the American Heart Association, you can expect your heart rate to be at around 70-85% of its maximum rate during high-intensity exercise and 50-70% of its maximum rate during moderate exercise. Your maximum heart rate is approximately 220 beats per minute (bpm) minus your age.

It’s also normal to feel your heart pounding in your chest, neck, or head during and after vigorous physical activity—especially if you haven’t exercised for a while. Your heart is working hard to supply oxygen to your limbs and muscles. The more deliberate breathing pattern you use while training also tends to make you more aware of your heartbeat.

When we talk about heart palpitations, we’re talking about a sensation that’s not normal. This could be:

  • Irregular heartbeats
  • Skipped beats
  • A heart flutter
  • A feeling that your heart is doing flip-flops in your chest
  • A heart rate that exceeds the recommended range for your activity level

While these sensations are common—many people also notice heart palpitations at night—there is usually a simple explanation for why they occur.

Common Causes of Heart Palpitations Before, During, or After Exercise

Heart palpitations occur for a wide range of reasons, many of which can be reversed with some small tweaks to your daily routine.

  • Stress. If you’re experiencing chronic emotional stress, it may be causing palpitations. Take time to deal with any issues that are causing stress, start a mindfulness or meditation practice, and see a therapist if you can’t reduce stress on your own.
  • Caffeine, alcohol, and certain foods. Ingesting large amounts of caffeine, alcohol, sugar, salt, and certain foods can bring on heart palpitations. We cover this in more detail in the article 10 Foods to Avoid If You Have Heart Palpitations.
  • Smoking. Nicotine consumption increases the risk of heart disease and stroke by a factor of 2 to 4. Quitting is one of the best things you can do for your heart and may reduce palpitations as well.
  • Certain medications. A wide range of prescription and over-the-counter medications may cause palpitations, including antibiotics, diet pills, antipsychotic drugs, asthma inhalers, cough and cold medications, high blood pressure medicines, antifungal medicines, and thyroid medicines.
  • Low potassium or magnesium levels. Be sure to include magnesium and potassium-rich foods in your diet and have a drink of coconut water or an electrolyte drink when you’re training especially hard.
  • Poor sleep or inadequate sleep. Adults need 7 to 9 hours of quality sleep every night. Poor sleep increases the risk of palpitations, high blood pressure, and heart disease.
  • High blood pressure (hypertension). Check your blood pressure at least once a year and make dietary and lifestyle changes if your BP is too high.
  • Intense exercise with minimal resting periods. Start slow and build up when starting a new exercise routine. Allow time for adequate rest between sets.
  • Hormonal changes, including pregnancy, menstruation, and menopause, can bring on heart palpitations. Take note if symptoms persist after the pregnancy, menstrual period etc. has finished.

Less Common—But More Serious—Causes of an Abnormal Heart Rhythm Before or After Exercise

While less common, an irregular heartbeat connected with exercise could be a sign of:

  • An arrhythmia, like atrial fibrillation
  • An abnormality in one of the heart valves
  • Coronary artery disease
  • Myocarditis

These conditions can be diagnosed with tests including an electrocardiogram (ECG or EKG), an echocardiogram, blood tests, and others. If it turns out that you have one of these conditions, your doctor will work with you to develop an appropriate treatment plan.

How to Work Out Whether the Arrhythmia Is Serious

Heart palpitations together with severe symptoms of chest pain, shortness of breath, dizziness, or fainting should always be treated as a medical emergency. Additionally, palpitations if you’ve had a heart attack before can be a warning sign before sudden cardiac arrest or sudden death. Seek immediate medical attention as you may need to be resuscitated with a medical-grade external defibrillator like the Philips HeartStart FRx, which is commonly kept in EMS vehicles and hospitals.

If your only symptom is an irregular heartbeat:

  1. Measure your pulse after exercise by counting the number of beats in 30 seconds and multiplying this number by two. This is your heart rate.
  2. After exercising, write down your heart rate, the kind of exercise you did, what you ate and drank in the last few hours, any medications you’re taking, and any other symptoms. This “heart journal” might help you to identify triggers and can be an invaluable resource for your doctor as well.

Exercising with Heart Arrhythmias

If you have been diagnosed with heart arrhythmia, it’s still extremely important to exercise regularly. Excess weight is also a risk factor for arrhythmias and heart disease, and staying active can help you maintain a healthy weight or lose excess weight.

Before starting a training program, talk to your doctor about the most appropriate kind of physical activity and come up with a plan that will allow you to increase your training regimen gradually. In general, cardio and yoga are safer than weight lifting, which puts extra stress on the heart. Get your doctor’s ok before traveling or training at high altitudes.

Heart Palpitations When Exercising – Usually Benign But See Your Doctor If Symptoms Persist

Feeling like your heart is racing, pounding, fluttering, or skipping a beat after exercising is a pretty common experience. Often, it can be traced back to things like excess caffeine intake, medications, or sleep deprivation. Other times, it may indicate a heart problem.

If you experience heart palpitations together with severe heart symptoms—at any time of day or night—seek medical attention. Otherwise, keep a journal that includes your heart rate and other relevant factors. This may help you uncover triggers that you can address and also provides more information to help your doctor work out what’s going on.

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