Pretty much anything can cause a fluttering sensation in chest. Seemingly out of nowhere you feel like butterflies are inside of you. It may be in response to exercise or feeling scared over something. It may last a few seconds, or up to a few minutes. Whatever the cause, it may leave you feeling concerned something is going on.

While there are several explainable causes, some may be cause for concern. If you are having actual heart palpitations, it could be anxiety or heart trouble. It is good to know the causes so you will know when you should see your doctor.

What Causes the Fluttering in Chest?

Fluttering sensation in chest can be worrisome. Some causes are very benign and related to emotions, reactions to fear or love, or something you ate or drank. Other causes may be something more serious and worthy of a doctor’s visit. Some of the causes include:

• Emotional reactions: You may have just had a passionate kiss, or a fright from a scary movie. Anxiety attacks and stressful situations may also cause a fluttery feeling in your chest.
• Hormones: Some women experience more chest fluttering and palpitations around the time of their period or during menopause. Thyroid disease can also cause an irregular heartbeat.
• Caffeine, smoking, alcohol, or stimulant drugs: If you just drank a cup of coffee or smoked a cigarette, your heart rate may be elevated and irregular for a while after. Using stimulants that are “street drugs” can also cause irregular heartbeats. This may feel like a “fluttering in chest.”
• Health Conditions: If you have diabetes, fluctuating blood sugar levels may cause heart palpitations. Low iron levels and anemia can also cause the heart to beat irregularly. Some people complain of this sensation with a fever as well.
• Dehydration. Not drinking enough fluids, especially in hot weather, can cause a fluttering in the chest. This can also happen if too much potassium and sodium are lost through sweating, vomiting, and physical exercise on hot days.
• Medications and supplements: Stimulant medications and herbal supplements with stimulants can cause increased and irregular heartbeats. Thyroid medications that replace thyroid hormones may also cause this to happen if your dose is too high. It is also common with inhalers used to treat asthma attacks.
• Diet: Eating a heavy meal can strain the heart and disrupt normal heartbeat patterns. Excess carbohydrates can also cause heart palpitations. It is also a known symptom of a reaction to sulfites, nitrates, and monosodium glutamate or MSG.
• Heart valve disease: If the heart valves do not work properly they can get stuck open or closed during heartbeats and give a sensation of fluttering in chest.
• Heart disease: Heart disease or history of a heart attack makes the heart more prone to irregular heart rhythms.

Will There Be Any Other Signs?

In most cases, heart fluttering is the only sign if the cause is benign and not heart related. Just a slight discomfort in the chest. In some cases where there is a heart condition, there may be other symptoms including:

• Trouble breathing
• Chest pressure
• Feeling lightheaded
• Chest pain
• Chest heaviness
• Fainting spells
• Blue lips and fingers
• Racing heartbeat (Over 100 beats per minute)
• Nausea and/or vomiting

**Any of these symptoms with an irregular heartbeat are considered a medical emergency and you should seek medical attention right away or call 9-1-1.

What Can Be Done?

If you have fluttering in chest on a regular basis, you should get things checked by your doctor. Never assume this is anxiety or something simple until you are cleared of a heart problem. There are a few tests your doctor can run, even right from the office. These include:

• A chest x-ray. The first test ordered may be a chest x-ray. Fluid in the lungs can often put a strain on the heart and cause abnormal heart beats. This happens with pneumonia and heart failure.
• An electrocardiogram. This test involves placing leads on the chest, arms, and legs. It will check the electrical signals from your heart. The doctor may even have you do some exercise to see if it can be induced. The test will tell your doctor if the fluttering is from an abnormal heartbeat.
• A Holter Monitor. This test is like the above EKG, but monitors the electrical activity of your heart over a few days’ time. You will keep a journal of the things you do, things you eat, and if you have emotional ups or downs during the test. You will also record what medicines you take and if you smoke or drink. This way the doctor can pinpoint any outside causes.
• An Echocardiogram. An ultrasound doppler can pick up images of the heart to look for any abnormalities in the valves or chambers of the heart. This can help look for valve disease.

If no cause is found, the doctor may want to keep an eye on you and have you keep a journal of the episodes. You may need a referral to a specialist if you have other symptoms. There are some simple lifestyle changes you can make that will help:

• Reduce caffeine intake
• Quit smoking
• Avoid stimulants
• Breathing exercises
• Eat smaller more frequent meals
• Yoga
• Aromatherapy
• Avoid cold medications and cough syrup
• Use caution with herbal supplements
• Avoid dehydration
• Use a sports drink with electrolytes during illness or exercise

If you do require medical treatment, the doctor may prescribe a medication that reduces the heart's reaction to stimulants like calcium channel blockers, central nervous system depressants, or a beta blocker.

If a heart condition is found, you may be referred to a cardiologist for further evaluation and treatment. Treatments in this case are tailored to the appropriate condition and can range from medications to surgery.