Heart Palpitations: 14 Possible Causes and Symptoms. Reviewed By: Charles Patrick Davis, MD, PhD

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What Do Heart Palpitations Feel Like?

Heart palpitations are common and often do not have a serious underlying cause.

Heart palpitations produce a sensation where it feels like the heart is fluttering, pounding, or skipping beats. Many people are scared when they feel heart palpitations. The good news is that most causes of heart palpitations are not serious and do not need treatment. If you know what causes heart palpitations, it may ease your mind when you feel them. However, some causes of heart palpitations are serious so you should learn when to be concerned about heart palpitations and when to see a doctor.

Stress and Anxiety

Stress and anxiety are common heart palpitations causes.

Heart palpitations symptoms are often brought on by stress and anxiety. These emotions cause a release of stress hormones that make your heart beat faster. Your body then goes into so-called "fight or flight," whether there is a real or imagined danger. Intense fear may cause a panic attack that is associated with symptoms like racing heart, difficulty breathing, chest pain, sweating, and chills. Panic attack symptoms may resemble those of a heart attack. If you are not sure whether you are experiencing a panic attack or a heart attack, seek medical attention right away.

Exercise

Some people get frequent heart palpitations when they exercise.

Exercise is healthy and necessary; however, some people get heart palpitations when they work out. The heart beats faster naturally when you exercise. If you feel fluttering or pounding, it might be because you are out of shape and haven't worked out for a while. Some people experience symptoms of arrhythmia or irregular heartbeat when working out.

Caffeine

If you notice heart palpitations after consuming caffeine, it might be a good idea to cut back.

When it comes to heart palpitations, anxiety is a common cause and it may be triggered by consuming caffeine. If you notice that your heart pounds faster after you have a morning latte, it may be a good idea to cut back. Caffeine acts as a stimulant that increases heart rate. It is found in coffee, but also in tea, chocolate, soda, energy drinks, and other foods and beverages. People who have healthy hearts do not experience heart palpitations when consuming caffeine in coffee, tea, and chocolate, according to the results of one study. It is not known whether caffeine in these foods may trigger heart palpitations in people who have heart trouble.

Nicotine Products

Nicotine in cigarettes and tobacco products may cause heart palpitations.

Cigarettes and tobacco products contain nicotine, an addictive substance that may increase heart rate and blood pressure. Quit smoking to protect your heart. It may take some time after quitting for your heart rate to slow down. Aids to help you quit smoking, including nicotine patches and nicotine replacement products, may make your heart race. Nicotine withdrawal may also be associated with palpitations. These symptoms should go away within 3 to 4 weeks after you quit.

Hormone Changes

Some women experience heart palpitations in pregnancy due to hormone changes.

Hormone changes associated with menstruation, pregnancy, perimenopause, and menopause may cause heart palpitations. Many women want to know how to stop heart palpitations during pregnancy and times associated with hormone changes. Heart rate fluctuations due to hormonal changes are usually temporary and not a cause for concern. Heart palpitations may also occur when a woman is anemic, which can happen during pregnancy.

Fever

Fever increases strain on your body and may produce heart palpitations.

When you have a fever when you are sick, your body metabolizes energy at a faster pace compared to when you are well. This may lead to palpitations. A fever of at least 100.4 F or greater is usually necessary to increase your heart rate.

Medications

Some prescription and over-the-counter medicines cause palpitations.

Certain medications may be associated with heart palpitations. Over-the-counter and prescription medications that may produce heart palpitations include:

  • Cold medicine
  • Cough medicine
  • Antibiotics
  • Antipsychotics
  • Thyroid hormone replacement
  • High blood pressure medication
  • Diet pills
  • Asthma inhalers
  • Antifungals

If your doctor prescribes one of these medications for you, ask about potential side effects including those that affect the heart. Report any side effects right away. Do not change the dose of a medication or skip a dose of a medication without speaking to your doctor first.

Low Blood Sugar

Low blood sugar is one potential cause of seemingly random heart palpitations.

Do you get heart palpitations randomly? If you get them when you are hungry it might be because your blood sugar dropped. When blood sugar is low, the body releases stress hormones that make you feel weak, shaky, and cranky. The release of adrenaline may also speed up your heart and cause heart palpitations. Eat regular meals and snacks and keep food with you to avoid low blood sugar.

Overactive Thyroid Gland

Continuous heart palpitations might be due to an overactive thyroid gland.

Do you get all day heart palpitations? You might have an overactive thyroid. The thyroid is a butterfly-shaped gland in the front of your neck. Thyroid hormone is used by every cell in your body to fuel metabolism and perform other activities. Excess thyroid hormone, or hyperthyroidism, can make your heart speed up. A deficiency in thyroid hormone, or hypothyroidism, is treated with thyroid replacement hormone. But if you take took much of this medication, it may also speed up your heart.

Heart Rhythm Problems

If you experience constant heart palpitations it might be due to an arrhythmia.

Are heart palpitations dangerous? That depends on the underlying cause. Some types of heart palpitations are caused by a cardiac issue called an arrhythmia. Some arrhythmias are not dangerous and some may potentially be dangerous.

  • Atrial fibrillation (Afib) is an arrhythmia that arises in the upper chambers of the heart. It causes the atria to flutter instead of beat. Afib may increase the risk of blood clots.
  • Supraventricular tachycardia causes a fast heartbeat. It starts in the heart's upper chambers.
  • Ventricular tachycardia causes a fast heartbeat that arises from abnormal electrical pathways in the ventricles, the heart's lower chambers.

Alcohol

Drinking alcohol is one of the potential reasons for heart palpitations.

Drinking alcohol may cause your heart to beat faster or to flutter. It may happen when you drink more, like during holidays or weekends. However, some people are so sensitive that they experience heart palpitations even when they drink a small amount of alcohol.

Premature Ventricular Contractions

Continuous heart palpitations caused by PVCs may be dangerous.

Extra heart beats that occur in the lower chambers of the heart are known as premature ventricular contractions (PVCs). These extra heart beats occur when the ventricles contract too soon. This alters your heart rhythm and you may sense fluttering or pounding or feel as if your heart jumps. Occasional PVCs are not a cause for concern if you have a healthy heart. If you have heart disease or get PVCs frequently, you may need treatment.

Cocaine and Illicit Street Drugs

Using illicit drugs may cause anxiety and heart palpitations.

Illicit drugs like cocaine, amphetamines, and ecstasy may lead to dangerous heart rhythms. Cocaine increases heart rate, blood pressure, and may trigger heart damage. Amphetamines activate the nervous system and increase heartbeat. Norepinephrine is released when you take ecstasy, which increases heart rate.

When to See a Doctor

See your doctor if you experience frequent heart palpitations accompanied by other bad symptoms.

Healthy people who experience only occasional heart palpitations that last for a short time usually do not have to see a doctor about their symptoms. However, you should see the doctor if you experience frequent heart palpitations especially if you have symptoms including:

  • Trouble breathing or shortness of breath
  • Light-headedness or dizziness
  • Pressure in your chest or chest pain
  • Wooziness or fainting

Detecting the Underlying Cause

See your doctor for evaluation if you experience heart palpitations and dizziness with other symptoms.

If you experience frequent or troubling heart palpitations symptoms, your doctor may evaluate the cause by running tests including:

  • Holter monitor: This is a test where you wear a portable ECG for 24 to 72 hours that captures the activity of your heart the whole time. It records episodes of arrhythmia and heart palpitations.
  • Event monitor: This test involves wearing a device for several weeks that records the activity of your heart. When you feel heart palpitations or other heart symptoms, you push a button and the device records what your heart is doing at that time.
  • Electrocardiogram (ECG): Many people are familiar with this test at the doctor's office. A series of electrodes are placed on the chest and other areas of the body to record the heart's rhythm.
  • Echocardiogram: During this test, the technician uses a probe that uses sound waves to image the function of the heart. An electrocardiogram is used to show blood flow through the heart and to analyze heart structures
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