Important: This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment.
Heart palpitations are the sensation of feeling your heartbeat more strongly, quickly, or irregularly than usual. They can be triggered by stress, exercise, caffeine, medications, and other everyday factors, but sometimes they occur because of an abnormal heart rhythm.
Most palpitations are harmless. But because they can occasionally point to something more serious, it helps to understand what causes them, what they typically feel like, and the specific situations that call for prompt medical attention. This guide walks through all of that, from the everyday triggers to the warning signs you shouldn’t ignore.
What are heart palpitations?
Palpitations are often defined as an increased awareness of your own heartbeat. According to Mayo Clinic, they’re feelings of having a fast-beating, fluttering, or pounding heart, and they’re considered a symptom, not a diagnosis on their own.
This distinction matters. Palpitations can happen even when your heart’s rhythm is completely normal, simply because you’ve become more aware of it. They can also happen alongside a genuine rhythm abnormality. Feeling palpitations doesn’t automatically tell you which situation you’re in, which is exactly why understanding the broader picture matters.
What do heart palpitations feel like?
People describe palpitations in a lot of different ways. According to Dr. Larry R. Jackson II, a cardiac electrophysiologist at Duke Health, common descriptions include:
- Racing
- Pounding
- Fluttering
- Flip-flopping
- Skipped or extra beats
Palpitations are often felt in the chest, but many people notice them in the neck or throat instead. They can occur during activity or while completely at rest, and episodes can last anywhere from a few seconds to several minutes, or occasionally longer.
What causes heart palpitations?
A wide range of everyday factors can trigger palpitations, and in many cases, no clear underlying cause is ever found. Understanding the common categories helps put your own experience in context.
Stress, anxiety, and strong emotions
Strong emotional responses, including stress, anxiety, panic, and fear, are among the most common triggers for palpitations. It’s worth being careful here: anxiety genuinely can cause this sensation, but palpitations have many other possible causes too. Assuming every episode is “just anxiety” can mean missing a different, more relevant explanation.
Caffeine, nicotine, and other stimulants
Coffee, energy drinks, nicotine, and certain recreational drugs all stimulate the nervous system in ways that can trigger palpitations. According to Mayo Clinic, stimulants including caffeine, nicotine, cocaine, and amphetamines are common, well-recognized triggers.
Exercise and physical activity
During exercise, your heart naturally beats faster and more forcefully to meet your body’s increased demand for oxygen. This can make the sensation of your own heartbeat more noticeable, even when nothing is actually wrong.
Medications
Certain medications can trigger palpitations as a side effect, including some decongestants, asthma medications, ADHD medications, and other stimulant-containing products. If you suspect a medication is causing palpitations, don’t stop taking it on your own. Talk to your healthcare professional first, since abruptly stopping some medications carries its own risks.
Hormonal changes
Hormonal shifts during pregnancy, menstruation, and menopause are recognized contributors to palpitations for many people.
Fever and other temporary conditions
A fever can temporarily increase your heart rate and make palpitations more noticeable. This type of trigger typically resolves once the underlying illness does.
Thyroid problems
An overactive thyroid, a condition called hyperthyroidism, is a well-documented medical cause of palpitations. Too much or too little thyroid hormone can both affect heart rhythm and rate.
Electrolyte imbalances and other medical conditions
Problems with electrolytes like potassium, sodium, or magnesium can affect how your heart’s electrical system functions. Low oxygen levels and anemia are also conditions doctors may evaluate when investigating unexplained palpitations. The American Heart Association specifically notes that triggers for premature, “extra” heartbeats can include problems with electrolytes such as sodium, potassium, or magnesium, alongside stress, exercise, and excessive caffeine.
Can heart palpitations be a sign of a heart problem?
Palpitations can sometimes be associated with an abnormal heart rhythm, called an arrhythmia. That said, feeling palpitations doesn’t automatically mean you have heart disease. Most palpitations, most of the time, aren’t dangerous.
Arrhythmias that can cause palpitations
A number of different rhythm problems can produce the sensation of palpitations, including atrial fibrillation, other rapid heart rhythms, and premature beats, where the heart’s upper or lower chambers contract earlier than expected. This is educational background, not a diagnostic checklist. Only appropriate testing can determine whether a specific rhythm problem is actually present.
When palpitations are more concerning
Certain factors raise the likelihood that palpitations deserve closer medical attention, including:
- A known history of heart disease
- New or changing symptoms
- Increasing frequency over time
- Episodes that last longer than usual
- Palpitations accompanied by other symptoms, like dizziness or chest discomfort
Heart palpitations symptoms
Beyond the core sensation itself, it helps to know which accompanying symptoms matter most.
Common symptoms
- Racing heartbeat
- Pounding heartbeat
- Fluttering
- Skipped beats
- Extra or unusually forceful beats
- A sensation felt in the chest, throat, or neck
Symptoms that may occur alongside palpitations
- Dizziness
- Lightheadedness
- Shortness of breath
- Chest discomfort
- Sweating
- Feeling faint, or actually fainting
These associated symptoms genuinely change the urgency of the situation. Palpitations alone, without any of these, are usually far less concerning than palpitations that come paired with one or more of them.
When should you worry about heart palpitations?
This is often the central question people have, and it deserves a direct, practical answer.
When to make a routine medical appointment
Consider scheduling an evaluation if your palpitations:
- Are new or unexplained
- Keep recurring over time
- Are becoming more frequent or more intense
- Last noticeably longer than they used to
- Affect your daily activities or quality of life
- Occur alongside known heart disease or significant cardiovascular risk factors
According to Mayo Clinic, palpitations that are infrequent and last only a few seconds usually don’t need formal evaluation. But if you have a history of heart disease and your palpitations occur frequently or seem to be worsening, that’s a reasonable reason to talk with your healthcare provider, who may recommend heart-monitoring tests.
When to seek emergency care
Seek emergency medical attention if heart palpitations occur along with:
- Chest discomfort or pain
- Fainting or loss of consciousness
- Severe shortness of breath
- Severe dizziness
This guidance is consistent across Mayo Clinic, MedlinePlus, and Cleveland Clinic, all of which identify this combination of symptoms as a reason for urgent evaluation. It’s worth being clear about something important: this combination doesn’t necessarily mean you’re having a heart attack. But it does mean the situation needs prompt, professional assessment rather than a wait-and-see approach. If chest discomfort is your main concern, CollectedMed’s guide to chest pain covers this symptom in more depth, including when it needs urgent evaluation on its own.
How are heart palpitations diagnosed?
Diagnosis generally starts with a detailed conversation about your specific episodes, followed by targeted testing based on what that conversation reveals.
Medical history and physical exam
Your healthcare provider will likely ask questions like:
- When did the palpitations start?
- How long do individual episodes last?
- How often do they occur?
- Do they start and stop suddenly, or build gradually?
- Do they feel regular or irregular?
- What were you doing when they happened?
- Do you use caffeine, alcohol, nicotine, or any particular medications?
- Are there any other symptoms alongside the palpitations?
Electrocardiogram (ECG/EKG)
An ECG records your heart’s electrical activity at a single point in time. It’s often one of the first tests used to evaluate palpitations, since it can reveal certain rhythm abnormalities directly.
Heart rhythm monitoring
Because palpitations often come and go unpredictably, a single ECG can easily miss them. Extended monitoring, using devices like a Holter monitor worn for a day or two, or a longer-term event monitor, gives doctors a much better chance of capturing what’s actually happening during an episode.
Blood tests
Blood tests can help identify or rule out some of the medical causes discussed earlier, including thyroid problems, anemia, and electrolyte abnormalities.
Echocardiogram and other tests
Depending on your symptoms, medical history, and initial findings, your doctor may recommend additional testing, such as an echocardiogram, which uses ultrasound to look at your heart’s structure and function. Not everyone with palpitations needs this level of testing; it’s generally reserved for situations where the history or initial results suggest it’s warranted.
How are heart palpitations treated?
Treatment depends heavily on the underlying cause, which is exactly why an accurate diagnosis matters so much before deciding on a treatment approach.
Addressing triggers
For palpitations tied to everyday triggers, general lifestyle measures often help:
- Reducing excessive caffeine intake
- Avoiding nicotine
- Limiting alcohol if it seems to trigger your symptoms
- Managing stress
- Getting adequate rest
- Avoiding stimulant-containing products when appropriate
These measures are reasonable starting points for mild, occasional palpitations. They aren’t a substitute for evaluation when symptoms are frequent, worsening, or accompanied by the warning signs covered above. If stress is a significant factor for you, CollectedMed’s guide to how to reduce stress covers practical, evidence-based techniques.
Treating an underlying medical condition
When palpitations trace back to a specific medical cause, treatment focuses on that underlying issue, whether that’s a thyroid problem, an electrolyte imbalance, anemia, or a medication that needs adjusting.
Treatment for arrhythmias
When palpitations are linked to a genuine arrhythmia, treatment options can range from medication to procedures that address the heart’s electrical activity directly. The right approach depends entirely on which specific rhythm problem is involved and how significant it is, which is a conversation for a cardiologist rather than something this guide can meaningfully generalize.
What can you do during an episode of heart palpitations?
If you’re in the middle of an episode, a few practical steps can help you and your healthcare provider understand what’s happening.
- Stop what you’re doing and sit down if you feel unwell.
- Pay attention to how long the episode lasts.
- Note your heart rate if you can safely measure it.
- Record any possible triggers, like caffeine, exercise, stress, or a recent medication.
- Note any associated symptoms, even mild ones.
- Seek emergency care right away if you develop chest pain, severe shortness of breath, fainting, or severe dizziness.
Keeping a simple symptom log over time, noting the date, duration, possible triggers, and any accompanying symptoms, can genuinely help a clinician spot patterns that a single office visit might miss.
Heart palpitations at night
Many people notice palpitations more when they’re lying quietly in bed, which raises understandable questions about why nighttime feels different.
Why nighttime palpitations feel more noticeable
According to Cleveland Clinic, heart palpitations at night usually aren’t harmful. Many people have the same palpitations during the day but simply don’t notice them because they’re busy and distracted. At night, with less noise and fewer distractions, the same sensation becomes much more apparent.
Possible triggers specific to nighttime
Common contributors to nighttime palpitations include caffeine or alcohol consumed earlier in the day, stress, hormonal changes, and sleeping position. Lying on one side can sometimes increase internal pressure in ways that make palpitations more noticeable.
When nighttime palpitations deserve evaluation
Nighttime palpitations that happen occasionally and pass quickly usually aren’t a cause for concern. But if your heart often races or pounds when you lie down, particularly on a recurring basis, it’s worth having it evaluated. Get help right away if nighttime palpitations occur along with trouble breathing or chest pain.
Heart palpitations vs. fast heart rate
These two terms get used almost interchangeably in everyday conversation, but they describe different things.
The key distinction
Palpitations refer to a sensation or awareness of your heartbeat. Tachycardia refers specifically to a heart rate that’s faster than expected. These overlap often, but not always.
You can experience palpitations without any dangerous underlying rhythm problem at all, simply because you’ve become aware of a perfectly normal heartbeat. Conversely, someone can have a genuine arrhythmia without ever noticing palpitations. Understanding this distinction helps prevent jumping to the conclusion that every noticeable heartbeat sensation means something is dangerously wrong.
Frequently asked questions
Are heart palpitations dangerous?
Most heart palpitations aren’t dangerous. They’re commonly triggered by everyday factors like stress, caffeine, or exercise. Rarely, they can signal a more serious heart rhythm problem, which is why persistent, worsening, or symptom-accompanied palpitations deserve medical evaluation.
What causes heart palpitations?
Common causes include stress and anxiety, caffeine and other stimulants, exercise, certain medications, hormonal changes, fever, and thyroid problems. In many cases, a specific cause is never identified, and the palpitations remain benign.
Can anxiety cause heart palpitations?
Yes, anxiety and strong emotional responses are among the most common triggers for palpitations. That said, not every case of palpitations is anxiety-related, so it’s worth considering other possible causes too, especially if symptoms are new or changing.
Can caffeine cause heart palpitations?
Yes. Caffeine is a stimulant that can increase heart rate and trigger the sensation of palpitations in many people, particularly with higher intake.
Why does my heart feel like it skipped a beat?
This sensation is often caused by a premature contraction, where the heart’s upper or lower chambers beat slightly early, followed by a pause that makes the next beat feel more forceful. This is usually harmless and common, though frequent or persistent episodes are worth mentioning to a doctor.
Are heart palpitations normal at night?
Noticing palpitations more at night is common and usually reflects reduced distraction rather than a new problem, since many people have the same sensations during the day without noticing. Frequent or worsening nighttime palpitations, especially with breathing trouble or chest pain, should be evaluated.
When should I see a doctor for heart palpitations?
See a doctor if palpitations are new, recurring, worsening, lasting longer than usual, affecting your daily life, or occurring alongside known heart disease or significant cardiovascular risk factors.
When are heart palpitations an emergency?
Seek emergency care if palpitations occur with chest discomfort or pain, fainting, severe shortness of breath, or severe dizziness. This combination needs prompt medical assessment.
Can dehydration cause heart palpitations?
Yes, dehydration and electrolyte imbalances can both affect heart rhythm and contribute to palpitations. Staying adequately hydrated is a reasonable general measure, though it isn’t a treatment for palpitations tied to other causes.
Can thyroid problems cause heart palpitations?
Yes. An overactive thyroid (hyperthyroidism) is a well-recognized medical cause of palpitations, and thyroid function is commonly checked as part of the diagnostic workup for unexplained or persistent cases.
How are heart palpitations diagnosed?
Diagnosis typically starts with a detailed medical history and physical exam, followed by testing as needed, including an ECG, extended heart rhythm monitoring, blood tests, and sometimes an echocardiogram, depending on what the initial evaluation suggests.
Can heart palpitations be treated?
Yes, though treatment depends entirely on the underlying cause. Lifestyle adjustments often help palpitations tied to everyday triggers, while palpitations linked to a medical condition or arrhythmia are treated by addressing that specific cause directly.
Key takeaways
- Heart palpitations describe an unusual awareness of your own heartbeat.
- They can feel like racing, pounding, fluttering, or skipped beats.
- Common triggers include stress, exercise, caffeine, nicotine, medications, and hormonal changes.
- Palpitations can occasionally be associated with an arrhythmia or another medical condition, though most are harmless.
- New, recurring, or changing palpitations deserve medical evaluation.
- Palpitations accompanied by chest pain, severe breathing difficulty, fainting, or severe dizziness require emergency medical attention.
Related reading on CollectedMed
- Chest Pain
- Shortness of Breath
- What Causes Dizziness?
- What Causes Fatigue?
- How to Reduce Stress
- How to Improve Sleep
- Benefits of Exercise
- What Is Diabetes?
Medical disclaimer
This article draws on publicly available guidance from the American Heart Association, Mayo Clinic, MedlinePlus, and Cleveland Clinic. Medical claims are linked to their original source at the point they’re made. This content is intended for general education and does not replace personalized medical advice.
Read our full Medical Disclaimer.
Sources
- Mayo Clinic. Heart Palpitations: Symptoms & Causes
- American Heart Association. How Serious Are Heart Palpitations? Causes, Symptoms and When to Worry
- MedlinePlus, National Library of Medicine. Heart Palpitations
- Cleveland Clinic. Heart Palpitations at Night
- Cleveland Clinic. Heart Palpitations
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