How to spot the signs of a heart arrhythmia

Your heart relies on a complex electrical system to keep it beating in a steady, coordinated rhythm.

When that system misfires, it can lead to a heart arrhythmia — a common condition that affects millions of people and often goes unrecognized.

Kelly Arps, M.D., a cardiac electrophysiologist at the University of Michigan Health Frankel Cardiovascular Center, explains what patients should know about symptoms, causes and when to seek care.

What is a heart arrhythmia?

A heart arrhythmia is a problem with the heart’s electrical system that causes the heartbeat to become too fast, too slow or irregular.

“There are many different types of arrhythmias,” Arps said. “Some are dangerous, some need treatment and some are completely benign.”

Arrhythmias can last only seconds, or they can persist for longer periods.

Some occur as occasional extra beats that interrupt an otherwise normal rhythm.

Common symptoms of an arrhythmia

The most classic symptom is heart palpitations — a sudden sensation that the heart is racing, pounding or fluttering.

“Patients often describe it as the feeling of their heart flip-flopping in their chest,” Arps said.

Other symptoms can be more subtle and may include:

• Unusual fatigue

• Shortness of breath

• Lightheadedness or dizziness

• Reduced ability to exercise

• Chest discomfort

• Feeling faint

“Some people don’t feel palpitations at all,” Arps said.

“They may come in because they just feel more tired or more short of breath, and testing later shows their symptoms were actually related to an abnormal rhythm.”

In some cases, arrhythmias are discovered during routine checkups.

When arrhythmia symptoms are an emergency

Certain symptoms should never be ignored.

Some people don’t feel palpitations at all. They may come in because they just feel more tired or more short of breath, and testing later shows their symptoms were actually related to an abnormal rhythm.”

-Kelly Arps, M.D. 

A sudden loss of consciousness without warning can be a sign of a dangerous heart rhythm, such as ventricular tachycardia or ventricular fibrillation, and requires immediate medical attention.

“If someone blacks out suddenly while sitting or resting and had no warning, that should be evaluated urgently,” Arps said.

Severe symptoms that interfere with daily life — such as extreme shortness of breath or persistent dizziness — should also prompt urgent evaluation.

SEE ALSO: Is your racing heart a sign of supraventricular tachycardia?

What causes heart arrhythmias?

Arrhythmias can occur for many reasons.

Some develop in people who already have heart disease – such as coronary artery disease or heart failure – and some develop in people who have had heart surgery for things like a heart valve problem.

Each puts strain on the heart muscle, which includes the electrical system.

Others occur in people with otherwise healthy hearts due to issues in the electrical system itself.

Over the course of a person’s life, people may develop different behaviors or conditions that put them at greater risk.

For common arrhythmias, such as atrial fibrillation, also known as Afib, risk factors include: