Palpitations

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If you’ve ever felt like your heart was racing or pounding, you may have experienced heart palpitations. This fluttering can be the result of an abnormal heart rhythm causing the misfiring of an electrical signal in the heart that makes it beat out of rhythm.

Palpitations can sometimes be frightful, especially if you have never experienced them. Fortunately, palpitations often are not a cause for concern. They most commonly occur at rest. Still, you should never ignore them, especially if you are at high risk of heart disease, as palpitations on rare occasions may be a sign of a more serious problem like valvular heart disease or hyperthyroidism (overactive thyroid). 

This article discusses the symptoms and potential causes of palpitations and highlights the significant risk factors you need to be aware of.

Palpitations

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Symptoms of Palpitations

Some people have palpitations every once in a while, while others have them more regularly. People experience different palpitation sensations but they typically are described as:

  • Feeling like your heart is skipping a beat
  • Feeling like your heart is throbbing or fluttering
  • A racing heartbeat
  • A pounding sensation in the neck or chest

The symptoms of nausea, shortness of breath, or sweating may also accompany your palpitations.

Palpitations—if associated with low blood pressure or heart failure—can sometimes also cause you to feel faint or light-headed.

Causes of Palpitations

Palpitations are commonly triggered by fear, anxiety or stress, strenuous exercise, or consuming too much caffeine, but sometimes the cause is unknown. They usually go away on their own without any treatment and people learn to live with this abnormal heart rhythm. 

The most common causes of palpitations are:

  • Stress or anxiety
  • Strenuous activity
  • Extreme fatigue
  • Hormonal changes caused by pregnancy, menopause, or menstruation
  • Caffeine
  • Nicotine
  • Alcohol
  • Stimulant medications, including Sudafed 12 Hour (pseudoephedrine)
  • Recreational drugs, such as cocaine, heroin, amphetamines, ecstasy, and cannabis
  • Rich or spicy foods
  • Pregnancy
  • Dehydration
  • Anemia
  • Panic attacks
  • Cardiomyopathy
  • Hyperthyroidism
  • Heart valve disease
  • Other, more dangerous arrhythmias

What Medications Can Cause Palpitations

As previously mentioned, some recreational drugs like cocaine and amphetamines can cause heart palpitations. Others like pseudoephedrine have become tightly regulated since they have been shown to increase heart failure risk in vulnerable populations.

It’s important to know which medications can trigger palpitations so that you know this connection should you experience this symptom. 

The following medicines can occasionally trigger palpitations:

It is always recommended that you consult your healthcare provider before reducing or stopping a prescribed medication. Never stop taking a prescribed treatment without first getting medical advice even if you believe that your medication is the cause of your heart palpitations.

How to Treat Palpitations

The specific treatment for your palpitations will depend on the cause of your symptoms. Most of the time, palpitations will go away on their own or may be resolved by doing the following:

  • Performing relaxation techniques such as yoga, meditation, and breathing exercises
  • Cutting back on the offending medication (but first consult your healthcare provider before reducing any medication that is prescribed to you)
  • Drinking more water 
  • Avoiding alcohol 
  • Cutting back on caffeine or spicy foods
  • Getting back to routine exercise

If the cause of your heart palpitations is due to thyroid problems, arrhythmias, atrial fibrillation, or another heart condition such as heart failure or valvular heart disease, you may need to take medications, surgery, or a pacemaker to correct your abnormal heart rhythm.

Therefore, if you experience heart palpitations and are at high risk of heart problems it is suggested that you contact a medical professional as soon as possible. 

Are There Tests to Diagnose the Cause of Palpitations?

Most people don’t experience heart palpitations during a medical visit. Your healthcare provider will take a detailed history, asking you about your medications, lifestyle habits, and past medical history. They may also perform a focused physical exam, listening to your heart with a stethoscope for signs of an abnormal heartbeat or arrhythmia. 

To determine what might be causing your heart palpitations, your healthcare provider may recommend or perform one of the following tests:

  • Blood tests: Blood tests may look at hormone (thyroid), electrolytes (potassium and sodium), and blood cell levels. 
  • Urine analysis: A urine test can detect stimulants that throw off the regular, steady pattern of the heart. A urine test measures catecholamine, electrolyte, blood cell, hormone, and blood sugar levels.
  • Echocardiogram: This test uses ultrasound to create an image of the heart that describes the size, shape, and motion of the heart. Irregularities in any of these three components can lead to arrhythmias that may cause heart palpitations. 
  • Cardiac stress test: Also known as a treadmill test, this exam tracks your heart rate and rhythm while you walk or run on a treadmill or ride a stationary bicycle.
  • Electrocardiogram (EKG): Detecting abnormalities on an EKG—a test involving attaching small electrodes to your chest to measure electrical impulses of the heart—is helpful in diagnosing cardiac causes of heart palpitations. Some heart conditions associated with palpitations that may be detected by EKG include arrhythmias and congestive heart failure. Of note, a Holter monitor is a portable EKG that can track your heart rhythm over the course of 24 hours. 
  • Chest X-ray (CXR): A CXR is a quick and inexpensive way to take a look at the anatomy of the heart and lungs.

Consult your healthcare provider if your test results are unclear or if you have any questions. After taking these exams you will likely meet with your healthcare provider who will explain the results and discuss your treatment options.

Diagnostic Tools

There are two general tools to diagnose the cause of palpitations:

When to See a Healthcare Provider

Palpitations are usually not harmful, but they may be a cause for concern if they are associated with any of the following symptoms: 

  • Dizziness, confusion, or light-headedness
  • Chest pain or pressure (like someone is sitting on your chest)
  • Difficulty breathing
  • Fainting (syncope) while having palpitations
  • Pain, pressure or tightness in your chest, neck, jaw, arm(s), or upper back
  • Unusual sweating

Get immediate medical attention if you have any of the aforementioned symptoms or if your palpitations are new, persistent, or getting worse. 

Summary

Palpitations are a common symptom most often caused by a benign cardiac rhythm abnormality. They are usually harmless, but in rare cases, they may be a sign of a serious medical condition.

A Word From Verywell

Palpitations are often not a cause for concern. However, it's best to let your healthcare provider know you are experiencing palpitations. Your provider can run tests to check for an underlying medical condition.

Frequently Asked Questions

  • What causes palpitations?

    Palpitations are an abnormal heart rhythm reflective of the misfiring of an electrical signal in the heart, causing it to beat out of rhythm. Strong emotional responses (as a result of fear, anxiety, and stress), strenuous activity, high amounts of caffeine, and structural abnormalities of the heart are the most common triggers of palpitations.

  • Are palpitations a sign of heart failure?

    Palpitations are not usually dangerous and are only rarely associated with heart failure.

  • How can I get rid of palpitations?

    If your palpitations occur once in a while, they may go away on their own or with simple home techniques. If your heart palpitations are due to more serious medical conditions you may need to take medication, have surgery, or use a pacemaker to help resolve your abnormal heart rhythm. 

  • How can I prevent palpitations?

    Eating a heart-healthy diet, never smoking and limiting alcohol, avoiding foods that trigger your palpitations, and limiting stress are great ways to prevent palpitations.

4 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.
  1. Johns Hopkins Medicine. Palpitations.

  2. Hollander-Rodriguez JC, Montjoy HL, Smedra B, Prouty JP. Clinical Inquiry: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? J Fam Pract. 2017 Jun;66(6):E1-E2.

  3. NHS. Heart palpitations and ectopic beats.

  4. Oxford Medical Education. Differential diagnosis for palpitations.

By Shamard Charles, MD, MPH
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.