What causes heart palpitations?

What Causes Heart Palpitations?

Heart palpitations are sensations that your heart is pounding, fluttering, racing or skipping beats. Most of the time they’re harmless—but they can also signal an underlying issue that needs attention. Here’s a clear, commonsense guide to what causes heart palpitations, when to worry, and what to do next.

What Are Heart Palpitations?

Heart palpitations feel like your heart is:

• Beating too fast (tachycardia)
• Fluttering or “flip-flopping”
• Skipping or extra beats (premature contractions)

You may notice them in your chest, throat or neck. They can last seconds to minutes, and sometimes even hours.

Common (Benign) Triggers

Often, palpitations happen in healthy people and aren’t dangerous. Common triggers include:

• Stimulants

• Caffeine (coffee, tea, energy drinks)
• Nicotine (cigarettes, vaping)
• Certain cold medicines (decongestants)

• Stress and Anxiety

• Sudden fright or panic attacks
• Chronic worry or high-pressure situations

• Physical Factors

• Exercise or heavy lifting
• Fever or dehydration
• Hormonal shifts (pregnancy, menstruation, menopause)

• Diet and Lifestyle

• High sugar or very spicy foods
• Large meals, especially late at night
• Alcohol binge or rapid tapering

Medical Causes and Underlying Conditions

Sometimes palpitations point to a health problem that should be treated. Key medical causes are:

• Heart-Related

• Arrhythmias (atrial fibrillation, supraventricular tachycardia, premature ventricular contractions)
• Valve problems (mitral valve prolapse, aortic stenosis)
• Cardiomyopathy (thickened or weakened heart muscle)
• Previous heart attack or heart failure

• Endocrine and Metabolic

• Overactive thyroid (hyperthyroidism)
• Low blood sugar (hypoglycemia)
• Electrolyte imbalances (potassium, magnesium)

• Medications and Supplements

• Asthma inhalers (beta-agonists)
• Thyroid hormone replacement
• Certain antidepressants or stimulants
• Overuse of herbal supplements (e.g., excessive ginseng)

• Other Medical Issues

• Anemia (low red blood cell count)
• Fever or infection
• Pheochromocytoma (rare adrenal gland tumor)

How to Tell If Palpitations Are Serious

Most palpitations are harmless and stop on their own. Yet you should seek medical care right away if you experience palpitations with:

• Chest pain or pressure
• Shortness of breath at rest
• Dizziness, lightheadedness or fainting
• Severe fatigue or sweating
• Swelling in legs, ankles or feet

These could indicate a serious arrhythmia, heart attack or other urgent cardiac condition.

Risk Factors That Raise Concern

Certain factors make palpitations more likely to signal trouble:

• Known heart disease or high blood pressure
• Family history of sudden cardiac death
• Diabetes or chronic kidney disease
• Use of illicit stimulants (cocaine, amphetamines)
• Age over 60 (higher risk of atrial fibrillation)

Diagnosing Heart Palpitations

If episodes are frequent, severe or alarming, your doctor may recommend:

• Electrocardiogram (ECG/EKG) to record heart rhythm
• Holter monitor (24–48 hour wearable ECG)
• Event recorder (for intermittent symptoms)
• Echocardiogram (ultrasound of the heart)
• Blood tests (thyroid function, electrolytes, blood counts)
• Exercise stress test

These tests help pinpoint whether palpitations come from a harmless trigger or a more serious heart problem.

Treatment and Management

Treatment depends on the cause and severity of your palpitations:

1. Lifestyle Changes

   • Cut back on caffeine, nicotine and alcohol
   • Manage stress with relaxation techniques (deep breathing, yoga)
   • Stay well-hydrated and maintain balanced electrolytes
   • Get adequate sleep and regular exercise

2. Medical Therapies

   • Beta-blockers or calcium-channel blockers to slow heart rate
   • Anti-arrhythmic drugs for rhythm control
   • Blood thinners if you have atrial fibrillation
   • Thyroid medication if hyperthyroidism is the cause

3. Procedures

   • Catheter ablation to destroy small areas causing abnormal signals
   • Pacemaker or implantable cardioverter-defibrillator (ICD) in select cases

Your doctor will tailor treatment to your specific diagnosis, overall health and personal preferences.

When to Seek Immediate Help

Call emergency services (911 in the U.S.) if palpitations come with:

• Crushing chest pain
• Sudden inability to breathe or speak
• Loss of consciousness
• Seizure

These signs could point to a life-threatening event like a heart attack or dangerous arrhythmia.

Staying on Top of Your Symptoms

If you’re ever unsure about your palpitations or other symptoms, you can try a free, online symptom check, using the doctor approved Ubie Symptom Checker. This tool can help you decide how urgently to seek care and which questions to ask your provider.

Final Thoughts

Heart palpitations are common and often harmless. By understanding triggers, watching for warning signs and talking openly with your doctor, you can get the reassurance or treatment you need. If anything feels off—especially chest pain, fainting or severe shortness of breath—speak to a doctor right away. Early evaluation and intervention can make all the difference.

Always trust your instincts: if palpitations worry you or interfere with daily life, don’t wait. Make an appointment, share your full history and get the tests you need to stay heart-healthy.