Heart Palpitations Symptoms

By Ashley Henshaw. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Heart palpitations are very common, and most of the time they are harmless.

But heart palpitations can also result from serious underlying problems and disordered heart rhythms called arrhythmias, some of which are life threatening. It is important to know more about this condition so that you can talk about your symptoms effectively with your doctor. 


Palpitations are unexpected sensations often described as “the feeling of your heart thumping in your chest.” The sensation can be fast, slow, regular or irregular. There is often an awareness of the heart, pounding, skipping, racing, fluttering, or doing a “flip-flop.” Some people feel palpitations in their throat or neck, and a few feel just a general sense that something is wrong.

Causes and Triggers

The list of things that can cause palpitations is long, and in as many as 16 percent of patients, no cause can be found. Of the causes that are noncardiac, anxiety may be the most common. Anxiety and heart disease are both very common conditions that can happen together, so authorities caution against being too quick to dismiss palpitations as anxiety. 

  • Stress and anxiety
    • When stress and anxiety are in play, the mind-body relationship is key. You may be more likely to notice palpitations when you are quietly resting, when your mind is not busy with other things, and you may have greater awareness of the heartbeat because of your anxiety.
  • Panic
    • Panic attacks are overwhelming surges of fear and anxiety during which heart palpitations and other symptoms, such as the feeling of being unreal and detached, are often present. People with panic attacks sometimes seek emergency care, believing they are having a heart attack.
  • Too much caffeine, chocolate, or alcohol
    • In one survey, nearly 20 percent of college students reported palpitations related to energy drinks containing caffeine.
  • Dehydration
  • Low potassium
  • Low blood sugar
  • Nicotine
  • Exercise
  • Standing up
  • Swallowing
  • Fever
  • Heart disease, prior heart attack
  • Mitral valve prolapse
  • Anemia
  • Overactive thyroid
  • Pregnancy
  • Menopause
  • Acid reflux (heartburn)
  • Low levels of oxygen in your blood 

Drugs, Medications, and Supplements as Triggers 

  • Cocaine, amphetamines, diet pills, other stimulants
  • Some cough and cold medicines
  • Some antibiotics
  • Thyroid hormone
  • Digoxin
  • Some asthma medications
  • Beta blockers
  • Anti-arrhythmics
  • Ephedra, ginseng, bitter orange, valerian, hawthorn 

Your Approach to Palpitations 

If your palpitations are accompanied by severe shortness of breath, chest pain, fainting or loss of consciousness, you should get medical attention immediately. Do not wait to call 911, since there are some serious potential complications in these instances, including injury from fainting, stroke, cardiac arrest or heart failure. 

If you know that your heart palpitations are caused by a serious underlying condition but you aren’t experiencing chest pain, fainting, severe dizziness or severe shortness of breath, you may still want to seek immediate medical attention. 

It helps if you can be very descriptive about your symptoms, and awareness of your heart rate (beats per minute) while having symptoms may also be helpful. 

If you are generally healthy, your palpitations were brief, and most importantly, there were not any other concerning signs or symptoms, you can make an appointment. Your doctor can help you find out if your palpitations are harmless or a symptom of a more serious condition.

Sometimes a cause cannot be pinpointed, and some experts recommend avoiding caffeine and alcohol as a first step, in concert with seeking medical advice. Avoiding too much caffeine and alcohol is always a good idea, and stress management and healthy living can have benefits far beyond any positive impact on heart palpitations.


Additional Resources:

Medline Plus

National Heart Lung and Blood Institute


Abbott AV. "Diagnostic approach to palpitations." Am Fam Physician. 2005;71(4):743-750. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.
Cleveland Clinic. "Arrhythmia: heart palpitations." www.my.clevelandclinic.org. Accessed May 8, 2013.
Harvard Medical School Family Health Guide. Skipping a beat—the surprise of palpitations. www.health.harvard.edu. Accessed May 8, 2013.
Kuijpers PM, Honig A, Griez EJ, Braat SH, Wellens HJ. [Panic disorder in patients with chest pain and palpitations: an often unrecognized relationship]. Ned Tijdschr Geneeskd. 2000;144(16):732-736. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.
Malinauskas BM, Aeby VG, Overton RF, Carpenter-Aeby T, Barber-Heidal K. A survey of energy drink consumption patterns among college students. Nutr J. 2007;6:35. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.
MedlinePlus. Heart palpitations. www.nlm.nih.gov. Accessed May 8, 2013.
Nabi H, Hall M, Koskenvuo M, et al. Psychological and somatic symptoms of anxiety and risk of coronary heart disease: the health and social support prospective cohort study. Biol Psychiatry. 2010;67(4):378-385. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.
National Heart Lung and Blood Institute. What are palpitations? www.nhlbi.nih.gov. Accessed May 8, 2013.
Reissig CJ, Strain EC, Griffiths RR. Caffeinated energy drinks--a growing problem. Drug Alcohol Depend. 2009;99(1-3):1-10. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.
Wexler RK, Pleister A, Raman S. Outpatient approach to palpitations. Am Fam Physician. 2011;84(1):63-69. www.ncbi.nlm.nih.gov. Accessed May 8, 2013.

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