Palpitations—the sensation that the heart has started to race or pound, or feels like it has skipped a beat—are usually caused by a harmless hiccup in the heart’s rhythm. Sometimes, though, palpitations reflect a problem in the heart or elsewhere in the body. Sorting out worrisome palpitations from harmless ones isn’t always easy, reports the September 2007 issue of the Harvard Heart Letter.

Palpitations are extremely common. Different people experience them in different ways. You might feel as though your heart is fluttering, throbbing, flip-flopping, or pounding, or that it has missed a beat. Palpitations can appear out of the blue and disappear just as suddenly. Or they might be linked with certain activities, events, or feelings. Some of the most important pieces of information that can help your doctor in pinning them down is how palpitations feel, how often they strike, and when they occur.

Some palpitations result from premature contractions of the heart’s chambers or malfunctions of a heart valve. But a physical exam and electrocardiogram often don’t turn up any problems, which can be frustrating to the patient. If your palpitations aren’t accompanied by dizziness or other symptoms and if you don’t have a valve disorder or other structural problem with your heart, that usually means palpitations are benign.

The Harvard Heart Letter suggests that if you have unexplained palpitations, start with simple steps to help alleviate them. Cut back on caffeine, smoking, and alcohol; avoid over-the-counter decongestants, eat and drink regularly, get enough sleep, and find a way to relax if you are stressed. In some cases, your doctor may recommend medications or a procedure to correct errant electrical signals in the heart.