What Are Heart Palpitations—And What Causes Them?

Medically reviewed by Rafle Fernandez, MD

Heart palpitations are feelings that your heart is beating very fast even at rest or that your hearts has skipped beats. You might feel a rapid fluttering or pounding sensation in your chest and neck.

Different lifestyle choices or scenarios can cause heart palpitations. Caffeine, nicotine, anxiety, medication, and exercise can all cause heart palpitations. Less often, health conditions like heart disease can cause heart palpitations.

Usually, heart palpitations are not a cause for concern. But knowing when to seek medical care for your heart palpitations—and how to stop them if you are feeling them or prevent them from occurring again—can be helpful.

What Do Heart Palpitations Feel Like?

Heart palpitations can feel different for each person. Typically, palpitations are sensations in which you might feel that your heart is pounding or racing.

Many people experience the feeling of the heart skipping a beat or stopping. Some people also describe palpitations as a flip-flopping in the chest, a rapid fluttering, or a pounding sensation in the chest, throat, or neck.

You usually don't pay attention or feel your heartbeat, so the awareness of it you have when you are experiencing heart palpitations can be unsettling.

What Causes Heart Palpitations?

Palpitations can have a number of causes ranging from mental health disorders to cardiac-related medical conditions. In many cases, the causes of heart palpitations can be addressed with treatment.

Anxiety

One of the most common causes of heart palpitations is anxiety. Many people with anxiety report a pounding or rapid heartbeat as a physical symptom of their condition.

Heart palpitations have also been liked to other psychiatric disorders like depression and panic attacks as well as general stress. Some research has found that the majority of people with mental health disorders experience heart palpitations.

People with anxiety might notice additional symptoms like behavioral changes, dizziness, and shortness of breath. A healthcare provider will typically first rule out any heart problems that might be causing the palpitations.

Lifestyle

Certain habits and activities can lead to heart palpitations. These include:

• Exercising, especially in more vigorous activities like running

• Drinking too much caffeine
  

• Smoking tobacco or marijuana

• Taking certain illicit, stimulant drugs

Medications

Certain medications have been linked to heart palpitations. You may experience heart palpitations while taking these drugs:

• Vasodilators, which help dilate your blood vessels

• Decongestants, like phenylephrine or pseudoephedrine

• Some asthma medications, like albuterol

• Some blood pressure medications, like chloroquine

In some cases, palpitations can happen as a result of stopping a medication. This can occur when you stop taking drugs like beta-blockers, which are often used to help manage heart rate.

Health Conditions

Conditions that affect your metabolism may cause heart palpitations. These conditions can include:

• Hypothyroidism, when the thyroid does not produce enough thyroid hormones

• Hyperthyroidism, when the thyroid produces too many thyroid hormones

• Hypoglycemia, when the body does not produce enough blood sugar

• Hypocalcemia, when blood does not have enough calcium

• Hypokalemia, when the body does not have enough potassium

• Hypomagnesemia, when the body does not have enough magnesium

The following conditions can also cause or worsen heart palpitations:

• Anemia, a lack of red blood cells

• Paget's disease, a chronic bone disease

• Fever

• Pregnancy

Heart Conditions

In some cases, palpitations can be a sign of a heart condition. Heart conditions that can cause palpitations include:

• Structural heart disease: This is a group of conditions that affect your heart's structures, including abnormalities in the valves, walls, chambers, or muscles of the heart.

• Premature ventricular contractions: In this condition, the lower two chambers of your heart contract too early which can affect blood flow to the body. This can feel like the heart is "skipping" a beat.

• Premature atrial contractions: In this condition, the upper two chambers of your heart contract too early which can affect blood flow to the body.

• Atrial fibrillation: ln this condition, also know as AFib, the upper chambers of the heart begin quivering or beating irregularly and too quickly. In some cases, people with AFib can experience shortness of breath, light headedness, chest pain, or heart failure.

• Ventricular tachycardia: In this condition, the lower two chambers of your heart start beating too fast. Besides having a heightened awareness of their heartbeat, people with ventricular tachycardia may experience additional symptoms like chest discomfort, fainting, lightheadedness, and shortness of breath.

Heart-related causes of palpitations should be addressed. A healthcare provider can help determine the best course of treatment.

How Can You Stop Heart Palpitations?

On their own, heart palpitations are usually not harmful and don't require treatment. Since anxiety and stress commonly cause heart palpitations, you can try calming yourself to see if this reduces the sensation. Practicing deep breathing has been shown to reduce stress.

When heart palpitations are the result of an underlying medical condition, the palpitations can often be managed by treating the condition. For example, in the case of pre-ventricular contractions, medications like beta blockers can help manage the condition and minimize palpitations.

How Can You Prevent Heart Palpitations?

If there's an underlying condition causing your heart palpitations, treating the condition might help prevent palpitations.

If a healthcare determines that a serious condition isn't causing your heart palpitations, try your best to ignore the feeling. Being hyperfocused on the palpitations can cause stress, exacerbating the palpitations.

Your healthcare provider may recommend certain lifestyle changes to help prevent future episodes of palpitations. These changes might include:

• Reducing your caffeine intake

• Quitting smoking cigarettes

• Getting regular exercise

• Practicing yoga, meditation, or other relaxation exercises

When to See a Healthcare Provider

While palpitations can be harmless, some palpitations may be the result of conditions that affect your heart and will require immediate medical attention.

If you experience any chest pain, shortness of breath, or lightheadedness alongside palpitations, you should seek immediate care. You should also get medical care if you or another person is having palpitations and experiences a sudden loss of consciousness.

In the emergency department, they will likely conduct a physical exam and run an electrocardiogram (EKG) to measure your heart's electrical activity. If the EKG is normal, they may recommend you follow up with your primary healthcare provider or cardiologist. Anything abnormal may need further testing.

You should also contact a healthcare provider if you suddenly have more palpitations than normal or your usual palpitations change in any way.

A Quick Review

Heart palpitations are sensations of your heart beating rapidly or skipping beats. Palpitations are usually no cause for concern, happening when you are experiencing anxiety or stress, when you have had caffeine, or when you are exercising. Less often, heart palpitations can occur due to a number of health conditions, some of which are serious heart conditions.

When an underlying condition is causing the palpitations, treating the condition can ease the palpitations. In other cases, your healthcare provider may recommend certain lifestyle changes like reducing stress or quitting smoking. It's important to talk to your healthcare provider about your palpitations to rule out any serious health condition and figure out your treatment options.

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