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​Causes of Heart Palpitations

Many things can cause palpitations. You may have these feelings even when your heart is beating normally or somewhat faster than normal.

Most palpitations are harmless and often go away on their own. However, some palpitations are signs of a heart problem. Sometimes the cause of palpitations can't be found.

If you start having palpitations, see your doctor to have them checked

Causes Not Related to Heart Problems

Strong Emotions

You may feel your heart pounding or racing during anxiety, fear, or stress. You also may have these feelings if you're having a panic attack.

Vigorous Physical Activity

Intense activity can make your heart feel like it's beating too hard or too fast, even though it's working normally. Intense activity also can cause occasional premature (extra) heartbeats.

Medical Conditions

Some medical conditions can cause palpitations. These conditions can make the heart beat faster or stronger than usual. They also can cause premature (extra) heartbeats.

Examples of these medical conditions are:

  • An overactive thyroid
  • A low blood sugar level​
  • Anemia
  • Some types of low blood pressure
  • Fever
  • Dehydration (not enough fluid in the body)​

Hormonal Changes

The hormonal changes that happen during pregnancy, menstruation, and the premenopausal period may cause palpitations. The palpitations will likely improve or go away as these conditions go away or change.

Some palpitations that occur during pregnancy may be due to anemia.

Medicines and Stimulants

Many medicines can trigger palpitations because they can make the heart beat faster or stronger than usual. Medicines also can cause premature (extra) heartbeats.

Examples of these medicines include:

  • Inhaled asthma medicines
  • Medicines to treat an underactive thyroid. Taking too much of these medicines can cause an overactive thyroid and lead to palpitations
  • Medicines to prevent arrhythmias. Medicines used to treat irregular heart rhythms can sometimes cause other irregular heart rhythms.

Over-the-counter medicines that act as stimulants also may cause palpitations. These include decongestants (found in cough and cold medicines) and some herbal and nutritional supplements.

Caffeine, nicotine, alcohol, and illegal drugs (such as cocaine and amphetamines) also can cause palpitations.

Causes Related to Heart Problems

Some palpitations are symptoms of arrhythmias. Arrhythmias are problems with the rate or rhythm of the heartbeat. However, less than half of the people who have palpitations have arrhythmias.

During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. An arrhythmia happens if some part of the heart's electrical system doesn't work as it should.

Palpitations are more likely to be related to an arrhythmia if you:

  • Have had a heart attack or are at risk for one
  • Have coronary heart disease (CHD) or risk factors for CHD
  • Have other heart problems, such as heart failure, heart valve disease​, or heart muscle disease.
  • Have abnormal electrolyte levels. Electrolytes are minerals, such as potassium and sodium, found in blood and body fluids. They're vital for normal health and functioning of the body.

If you are experiencing heart palpitations, you should contact your doctor to help determine the cause and seriousness of your palpitation.

Symptoms of Heart Palpitations

Symptoms of palpitations include feelings that your heart is:

  • Skipping a beat
  • Fluttering
  • Beating too hard or too fast

You may have these feelings in your chest, throat, or neck. They can occur during activity or even when you're sitting still or laying down.​​

Palpitations often are harmless, and your heart is working normally. However, these feelings can be a sign of a more serious problem if you also:

  • Feel dizzy or confused
  • Are light-headed, think you may faint, or do faint
  • Have trouble breathing
  • Have pain, pressure, or tightness in your chest, jaw, or arms
  • Feel short of breath
  • Have unusual sweating

Your doctor may have already told you that your palpitations are harmless. Even so, see your doctor again if your palpitations:

  • Start to occur more often or are more noticeable or bothersome
  • Occur with other symptoms, such as those listed above

Your doctor will want to check whether your palpitations are the symptom of a heart problem, such as an arrhythmia.

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

If you are experiencing heart palpitation symptoms, schedule an appointment with your physician or a cardiologist. They will work with you, run the appropriate tests for diagnosis and create the right treatment plan, if necessary. If you are in need of a trusted physician, call 1.855.922.9567​.

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