Heart Health Heart Disease Palpitations & Arrhythmias Arrhythmia Guide Arrhythmia Guide Symptoms Causes Diagnosis Treatment Symptoms of Cardiac Arrhythmias By Richard N. Fogoros, MD facebook linkedin Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Richard N. Fogoros, MD Medically reviewed by Medically reviewed by Yasmine S. Ali, MD, MSCI on June 15, 2020 facebook twitter linkedin Yasmine Ali, MD, is board-certified in cardiology. She is an assistant clinical professor of Medicine at Vanderbilt University School of Medicine and an award-winning physician writer. Learn about our Medical Review Board Yasmine S. Ali, MD, MSCI on June 15, 2020 Print Table of Contents View All Classic Symptoms Other Symptoms When to See a Doctor Next in Arrhythmia Guide What Causes Cardiac Arrhythmias? Cardiac arrhythmias can produce a range of symptoms, from very mild (or even none) to life-threatening. These symptoms can be divided into a “classic” group of symptoms that should make a doctor look specifically for a cardiac arrhythmia as the likely cause and an “other” group of symptoms that are just as likely to be caused by other medical conditions. © Verywell, 2018 Classic Symptoms Many people who are diagnosed with a cardiac arrhythmia will express surprise that they have experienced no symptoms. However, it is the case that many times cardiac arrhythmias may not produce any symptoms at all. This is especially true for arrhythmias that produce intermittent “extra” heart beats—premature atrial complexes (PACs) and premature ventricular complexes (PVCs). Others may experience these classic symptoms. Palpitations Palpitations are an unusual awareness of the heartbeat. They are commonly experienced as disturbing skips or pauses, intermittent heartbeats that feel too strong or pounding, episodes of rapid or “runaway” heartbeats, or heartbeats that are perceived to be irregular instead of steady. Palpitations affect different people in different ways. Some people don’t find them particularly annoying, while others find them extremely distressing and frightening. Almost any cardiac arrhythmia can produce palpitations, including the many types of bradycardia (slow heart rates) and tachycardia (rapid heart rates), PACs and PVCs, or episodes of heart block. Lightheadedness If a cardiac arrhythmia is preventing the heart from pumping blood sufficiently to provide the body’s needs, episodes of lightheadedness may result. When an arrhythmia is producing lightheadedness, it is more likely to do so when you are upright, or when you are doing something active. Resting or lying down tends to improve this symptom. Lightheadedness is a common symptom that has many potential causes in addition to arrhythmias. But when an arrhythmia produces lightheadedness, it is a sign that the arrhythmia itself may be dangerous, and may lead to even more severe problems such as syncope or even cardiac arrest. Because lightheadedness may be a sign of a potentially dangerous problem, this is a symptom that should never be ignored, but should always be evaluated by a physician. Syncope Syncope, or transient loss of consciousness, is a fairly common problem that (like lightheadedness) has numerous potential causes, many of which are pretty benign. But when syncope is caused by a cardiac arrhythmia, that’s a good sign that the arrhythmia itself is quite dangerous. It usually means that the arrhythmia is preventing the brain from receiving enough oxygen to maintain consciousness. Episodes of syncope can result from either bradycardia (if the heart rate is slow enough), or tachycardia (if the heart rate is fast enough). If such an arrhythmia were to persist for more than thirty seconds (which is long enough to produce syncope), a cardiac arrest might ensue. For this reason, an episode of unexplained syncope always requires a full medical evaluation, to pinpoint the underlying cause. Any arrhythmia that has caused syncope should be considered potentially life-threatening and should be treated aggressively. Cardiac Arrest A cardiac arrest occurs when a persistent, severe cardiac arrhythmia stops the flow of blood to the brain for a prolonged period of time. The difference between an arrhythmia that produces syncope and one that produces cardiac arrest is simply how long the arrhythmia persists. While severe bradycardia may cause a cardiac arrest, most often this condition is produced by ventricular fibrillation or ventricular tachycardia. Cardiac arrest invariably leads to rapid death (and is the main cause of sudden death), unless either the arrhythmia terminates by itself, or effective cardiopulmonary resuscitation is administered within a very few minutes. Anyone who has survived a cardiac arrest should be considered to be at high risk for subsequent episodes of cardiac arrest and should receive aggressive and effective therapy. Most of these people will be strong candidates for an implantable defibrillator. Cardiac system without and with arrhythmia. Other Symptoms In addition to these classic symptoms, cardiac arrhythmias may also produce several less specific, more generalized symptoms that may not necessarily point a doctor toward considering an arrhythmia as the cause. Most of these “other” symptoms are related to an arrhythmia causing a relative reduction in the ability of the heart to pump blood to the body’s organs. These symptoms are more likely to occur when a person is upright or exerting him/herself; and in people who have other medical conditions in addition to the arrhythmia, such as heart failure, diabetes, lung problems, or coronary artery disease. These symptoms include: Generalized weaknessConfusionDyspnea (shortness of breath)Poor exercise toleranceChest pain When to See a Doctor Any of these symptoms should prompt a visit to the doctor. An episode of severe lightheadedness or unexplained syncope should be evaluated immediately, and warrants a call to 911. Arrhythmia Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. While many cardiac arrhythmias are fairly common and usually benign, others are dangerous and need to be treated. This means it is important for your doctor to identify whether an arrhythmia is producing your symptoms, and if so, which specific arrhythmia is causing the problem, and how aggressive to be in treating it. Was this page helpful? Thanks for your feedback! Did you know the most common forms of heart disease are largely preventable? Our guide will show you what puts you at risk, and how to take control of your heart health. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kobayashi Y. How to manage various arrhythmias and sudden cardiac death in the cardiovascular intensive care. J Intensive Care. 2018;6:23. doi:10.1186/s40560-018-0292-x American Heart Association. What is an Arrhythmia? 2015. Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurol Clin Pract. 2011;1(1):24-33. doi:10.1212/CPJ.0b013e31823d07b6 Institute of Medicine (US) Committee on Social Security Cardiovascular Disability Criteria. 13, Arrhythmias. In: Cardiovascular Disability: Updating the Social Security Listings. 2010. John Hopkins Medicine. Ventricular Tachycardia. Patel PR, Quinn JV. Syncope: a review of emergency department management and disposition. Clin Exp Emerg Med. 2015;2(2):67-74. doi:10.15441/ceem.14.049 Gu X-M, Li Z-H, He Z-J, Zhao Z-W & Liu S-Q. A meta-analysis of the success rates of heartbeat restoration within the platinum 10 min among outpatients suffering from sudden cardiac arrest in China. Mil Med Res. 2016;3:6. doi:10.1186/s40779-016-0071-8 Watson RDS, Gibbs CR & Lip GYH. Clinical features and complications. BMJ. 2000;320(7229):236-239. doi:10.1136/bmj.320.7229.236 Additional Reading Schreiber D, Sattar A, Drigalla D, Higgins S. Ambulatory Cardiac Monitoring For Discharged Emergency Department Patients With Possible Cardiac Arrhythmias. West J Emerg Med 2014; 15:194. Kenny RA, Brignole M, Dan GA, et al. Syncope Unit: Rationale And Requirement--The European Heart Rhythm Association Position Statement Endorsed By The Heart Rhythm Society. Europace 2015; 17:1325.