What causes heart palpitations, how common are they, and how do I know they are occurring?
With heart palpitations, a person may notice that their heartbeat does not feel right. Many factors can trigger these heart flutters and in some cases, they can also indicate an underlying heart problem.
People are not usually aware of their heartbeat, but sometimes, it comes to their notice. This may be because their heart is pounding too hard, too fast, too slow, or irregularly.
This article explores the causes of heart palpitations, how to test for them, and some treatment options.
Many factors can trigger heart palpitations. Some causes include physical or mental stress, anxiety, dehydration, and lack of sleep.
However, they can also indicate an underlying heart problem.
The British Heart Foundation notes that palpitations can stem from a wide range of underlying heart conditions, such as:
- cardiomyopathy, wherein the heart becomes enlarged
- heart valve problems
- congenital heart disease
Palpitations can also result from arrhythmia, which refers to any change to a person’s regular heartbeat.
Causes of arrhythmia include:
- atrial flutter, which is a fast and irregular heartbeat
- ventricular tachycardia, which occurs when the lower chambers of the heart pump too fast, reducing the amount of oxygen in the blood
- atrial fibrillation, which is when there is a short circuit in the heart that causes the atria, or upper chambers in the heart, to pump rapidly
- supraventricular tachycardia, which is when the heart suddenly beats a lot faster than normal
It may also be a warning sign of heart failure or a heart attack, both of which can result from a range of structural and other issues.
Strong emotions can cause heart palpitations.
Emotional factors that can trigger heart palpitations include:
- insomnia or lack of sleep
Heart palpitations most commonly occur due to anxiety-related causes.
What is the link between anxiety and heart palpitations?
Certain medications can also trigger heart palpitations.
According to the United Kingdom’s National Health Service (NHS), the following medicines may trigger palpitations:
- asthma inhalers
- high blood pressure medications
- antifungal medications
Medication for attention deficit hyperactivity disorder, such as Adderall, may also cause heart palpitations.
Certain underlying medical conditions may be the cause of heart palpitations. These include:
- an overactive or underactive thyroid
- low blood sugar levels
- high or low potassium levels
- levels of magnesium that are too low or high
- pheochromocytenia, which is a type of neuroendocrine tumor
Other medical conditions include:
- postural hypotension, which is when a person experiences dizziness and low blood pressure when standing up
- a high fever
- sleep apnea
Lifestyle factors that may cause heart palpitations include:
- caffeine consumption, including tea, coffee, or energy drinks
- alcohol consumption
- tobacco smoking
- strenuous exercise
- using recreational drugs, such as cannabis, cocaine, heroin, ecstasy, or amphetamines
- rich or spicy food consumption
Why do heart palpitations happen after eating?
Hormonal changes are another possible cause. Changes in hormone levels may result from:
- menstrual periods
- thyroid problems
Learn more about why heart palpitations happen here.
Are they normal?
A 2021 article states that heart palpitations are very common and typically harmless.
In many cases, palpitations can be scary but not serious. However, they can be a symptom of arrhythmia and may also be a warning sign of cardiac arrest.
For this reason, it is a good idea for people who experience heart palpitations to seek medical advice.
People experience heart palpitations in different ways.
The NHS notes that some common descriptions include the heart:
- beating harder, faster, or irregularly
A person may feel a heart palpitation in the neck, throat, or chest. They may also feel them in their ear if they are lying down.
For some people, palpitations last for only a few seconds, while others may experience them for minutes or hours at a time.
How do doctors diagnose the cause?
A doctor will likely:
- ask about symptoms
- carry out a physical exam
- look at the individual’s medical history
- do a test using a 12-lead electrocardiogram (ECG)
An ECG measures heart rate and rhythm parameters through electrical tracing.
Depending on the symptoms, the doctor may also do blood tests, an exercise stress test, and other investigations, such as asking the person to wear an arrhythmia monitor at home.
They may also refer the person to a cardiologist.
People may find it useful to keep a diary noting the following information:
- what their palpitations feel like
- how often they happen
- when they happen
- what the triggers are
- whether they last for seconds, minutes, or hours
Being able to answer some of the following questions may also help with diagnosis:
- Is the heart rate too fast or slow during a palpitation episode, and is the rhythm regular or irregular?
- Is there lightheadedness, dizziness, shortness of breath, or chest pain?
- Do the palpitations tend to occur during a particular activity? Is there a pattern?
- Do the palpitations start and stop suddenly or fade in and out?
Not everyone with heart palpitations will need treatment. If they do, it will depend on the type of palpitations, the person’s symptoms, and the cause and amount of palpitations they are experiencing. Options include:
- Emotional causes: A person may find it beneficial to learn how to deal with a panic attack and use breathing techniques to help remain calm.
- Medication: If a person starts to have palpitations while taking certain medications, a doctor may recommend an alternative.
- Lifestyle: The heart palpitations should resolve without treatment, and people may find it beneficial to avoid the triggers.
- Hormonal: Heart palpitations that occur due to hormonal changes are usually temporary.
The doctor may prescribe antiarrhythmic drugs, such as beta-blockers or non-dihydropyridine calcium channel blocker therapy. Beta-blockers slow the heart rate and reduce blood pressure.
If a person has arrhythmia, a healthcare professional may recommend the following medical procedures:
- Catheter ablation surgery: During catheter ablation surgery, a cardiologist will thread an ablation device into the heart through a catheter that passes through a deep vein in the groin, neck, or chest. The device causes scars to form over faulty electrical tracts in the heart. This can help correct the way electrical impulses travel through the heart.
- Electrical cardioversion: This procedure involves sending an electrical shock into the chest wall to try to stabilize a person’s heart rhythm and rate. A doctor may choose this therapy to “reset” the electrical rhythm of the heart.
- Implantable pacemaker or defibrillator placement: A pacemaker is a permanent cardiac device that monitors and treats electrical conditions of the heart.
Some people experience regular palpitations, which may be bothersome. To reduce these, a person can try the following:
- Find a comfortable position and relax.
- Perform deep breathing techniques.
- Try to avoid panic, as this can worsen symptoms.
- Take magnesium supplementation, although a person should discuss this with a doctor first.
- Stay hydrated.
People may also try the Valsalva maneuver breathing method. A 2015 study found that the Valsalva maneuver is a simple and noninvasive method for stopping an abnormal heart rhythm. However, the researchers also noted that more research is necessary.
Get some tips on how to stop heart palpitations here.
Many cases of heart palpitations are harmless. However, if they are a sign of an underlying heart condition, there can be serious complications.
Some heart conditions, such as atrial flutter, can lead to stroke.
Heart palpitations can also be a symptom of heart failure and may precede cardiac arrest.
Some people may faint due to a sudden drop in blood pressure. Always get palpitations checked out and discuss management with a healthcare professional.
Often, lifestyle strategies can help reduce or stop nonserious palpitations. For example, people should try to reduce or avoid the following:
- any medications that may trigger palpitations
Other tips include:
- following a healthy diet
- getting enough sleep
- getting regular exercise
- doing yoga, meditation, breathing exercises, or tai chi to help manage stress
- avoiding known triggers or learning new ways to approach them
These measures may also help reduce the risk of heart disease.
Visit our cardiovascular health hub to learn more about the functioning of the heart.
When to contact a doctor
Heart palpitations usually pass quickly and are not serious, but it is a good idea to speak with a doctor if they occur.
If a person of any age experiences heart palpitations, they should contact a doctor. In addition, anyone with the following should contact a doctor if palpitations occur:
- a history of heart problems
- palpitations that worsen or do not improve
- other symptoms, such as chest pain
- other health concerns
Many people experience heart palpitations from time to time. They can be non-severe, and some people will not need treatment. However, they can also indicate an underlying health condition.
For this reason, people should seek help if the palpitations occur unexpectedly or often, if they have an existing heart condition, or if they have other symptoms.
Read this article in Spanish.