Heart palpitations are common and can feel like your heart is missing or skipping a beat, adding an extra beat, beating too fast or fluttering.

Palpitations get your attention, coming as they do from that area of the heart. Most are harmless but they also can signal a more serious heart condition, like coronary artery disease, congestive heart failure and heart valve problems.

Stress brings them on

“Typically they occur in people facing stressful situations, physical or emotional,” said Kelly Olson, a Marshfield Clinic cardiology nurse practitioner. “If they smoke, drink alcohol or caffeinated soda, or use street drugs, those can all irritate the heart and cause palpitations as well.”

They are also commonly felt during pregnancy because of hormonal changes.

Olson said about 90 percent of people have had palpitations at least to some point. Most do not seek treatment until the condition gets more bothersome or even frightening.

If you seek treatment, your doctor will order lab tests to evaluate electrolytes, important minerals in your blood, and look for low potassium or magnesium levels, screen for anemia and assess thyroid function. Any of these conditions can cause palpitations.

Having other symptoms?

Your provider will want to know if you’re having any other current symptoms like chest pain or tightness, shortness of breath or dizziness. The doctor will also ask about any history of palpitations in your family and your own history.

For further detail, a 48-hour Holter, or event monitor, may be ordered to evaluate for extra beats and/or arrhythmia.

If you report palpitations that occur with exertion, a stress test may be ordered to determine if exercise causes significant ectopy or arrhythmia.

“All of these tests help us determine how aggressive we may need to be in our treatment,” Olson said.

Many palpitations go away on their own. Others may require lifestyle changes in diet, like avoiding foods containing alcohol and caffeine; reducing anxiety and stress through regular exercise or relaxation to include organized groups such as yoga; and taking prescription medications.