Know When to Worry About Heart Palpitations (2023)

Heart palpitations can be temporary sensations. Your heart may be beating faster or harder or skipping a beat out of its normal rhythm.

While they can come from exercise or stress, heart palpitations can also signal heart trouble. They should be taken seriously if you have heart disease, are at high risk for heart disease, or if the palpitations come with other symptoms or the symptoms are persistent and bothersome.

It’s important to know the many factors that can trigger heart palpitations. This can help you know when they aren’t a cause for concern or when they indicate a potentially serious health problem.

Heart palpitations are changes in your heartbeat that are significant enough for you to notice them. Palpitations are signs that your heart rate has increased or changed in some way.

The sensation may be normal and predictable, like a racing heart following a good run.

But heart palpitations can also be unusual heartbeats due to a change in the heart’s electrical system. This can cause your heart to speed up with no obvious reason, “skip a beat,” or slow down. These abnormal rhythms are called arrhythmias and often require medical care.

Changes in your heart rate that result in palpitations are typically caused by factors that affect the intensity or rhythm of your heartbeat. Common causes include:

  • exercise and heavy physical exertion
  • use of caffeine, nicotine, alcohol, or narcotics
  • certain medications
  • stress, anxiety, or other mood disorders
  • hormone changes
  • arrhythmias and other heart conditions
  • electrolyte abnormalities
(Video) When to Worry about Heart Palpitations l Podcast l Vejthani Hospital

Heart palpitations can be described in different ways. The following terms describe the different types of sensations you may notice in your chest:

  • pounding
  • thudding
  • racing
  • fluttering
  • flip-flopping
  • murmuring
  • skipping

You may also feel palpitations radiating to your neck.

Heart palpitations may accompany other symptoms, such as general uneasiness. However, feelings of impending doom may also be symptoms of a heart attack.

Other symptoms that sometimes appear with heart palpitations include:

(Video) Heart Palpitations - Causes, When to worry about heart palpitations?

  • sweating
  • excessive thirst
  • dizziness
  • shortness of breath
  • nausea
  • chest pain
  • feeling lightheaded

While heart palpitations in any setting may be concerning, they can be fleeting changes in your heart rate that are responses to various stimuli, rather than symptoms of an underlying health condition.

However, there are some situations when you should see a healthcare professional soon or get emergency medical attention.

Benign causes

Many types of heart palpitations are the result of common causes that can get better when the triggers are removed, such as:

  • Exercise. If you get your heart rate up while running, swimming, or doing some other aerobic activity, you can expect to feel your heart beating harder during and immediately after exercise. Palpitations should start to fade once you’ve stopped exercising.
  • Diet. Your diet may also bring on heart palpitations. A high-carb meal may trigger palpitations if you have low blood sugar. Likewise, an extra cup of coffee or a caffeine-packed energy drink may get your heart racing and your head buzzing a little. But as the caffeine wears off, so too should those side effects. Drinking alcohol may cause palpitations, too.
  • Stress. Events such as giving a public presentation, swerving to avoid an accident on the road, and other brief moments of stress may trigger heart palpitations, sweating, nausea, and other physical responses. These should be temporary sensations.

Moderate concern

Heart palpitations that occur in the following situations should be of concern but may not be a medical emergency. Because they could be signs of an underlying health condition, you should make an appointment to discuss them with a healthcare professional.

  • Anxiety. Excessive worry can activate the body’s autonomic nervous system (the so-called fight-or-flight response). If the following symptoms of anxiety begin to interfere with your usual functioning, tell your doctor or seek the help of a mental health professional:
    • heart palpitations
    • rapid breathing
    • tense muscles
    • nausea
  • Pregnancy. Your body goes through many changes throughout pregnancy. Among them are increases in your heart rate and in the amount of blood circulating throughout your body. The result can be heart palpitations that may come on suddenly or with exercise. You can also have palpitations as a result of pregnancy hormones. They are usually brief episodes but may occasionally be signs of something more serious. If they persist, tell your doctor promptly.
  • At night. Heart palpitations at night may be brought on by changes in your breathing while you are sleeping. If they happen recurrently, they could signal an arrhythmia or other condition that should be evaluated.

Serious concerns

The three main signs that your heart palpitations may be an early sign of a health problem include:

  • when they linger long after they should have subsided
  • when they come on frequently for no apparent reason, such as from exercise, stress, or caffeine consumption, as this may point to an arrhythmia
  • when they are accompanied by heart attack or arrhythmia symptoms, such as chest pain, nausea, shortness of breath, overwhelming anxiety, and unusual sweating

If you have symptoms of a heart attack, you should call 911 or go to a hospital emergency department.

However, if you’re unsure how to respond to heart palpitations, but that voice in your head is telling you that something is wrong, trust your instinct. It’s always better to err on the side of caution and get a proper medical evaluation than take your chances when you may be in the middle of a medical emergency.

(Video) What causes heart palpitations or a heart flutter?

Tips for coping with heart palpitations

When you feel palpitations coming on, there are often steps you can take to stop them. These include:

  • Manage stress. Learning relaxation strategies, such as breathing techniques, meditation, yoga, and tai chi, may help prevent stress-related heart palpitations and ease them if they start.
  • Try vagal maneuvers. The vagus nerve runs from the brain to the heart and plays a role in regulating your heart rate. Various strategies can help stimulate the vagus nerve and return your heart rate to its normal level. Splashing cold water on your face or taking a cold shower might work. You can also try holding your breath for a few seconds or bearing down as if you were having a bowel movement.
  • Rehydrate. Drinking a glass of water or a sports drink packed with electrolytes may help ease palpitations from dehydration or electrolytes. Taking this break can also divert your attention to something other than what may be stressing you out.

Before you see a doctor about heart palpitations, think about how best to describe them (pounding, fluttering). You’ll likely be asked some or all of the following questions:

  • When did the palpitations start?
  • How long do they usually last?
  • How often are they occurring?
  • Does anything help ease them? Anything that makes them worse?
  • Do certain activities usually precede palpitations?
  • Do you have any other symptoms?

Before going into your appointment, think about the details of your medical history, family medical history, and make a list of all medications and supplements you take.

(Video) Heart Skips, Flips, Flutters, and Palpitations - When Should Women Worry

One of the main tests your doctor may recommend to better understand your heart palpitations is an electrocardiogram (ECG). Electrodes are placed on your chest to record the electrical signals that regulate your heartbeat. You may also have a stress test, as well as blood tests, to look for signs of thyroid disease, vitamin deficiencies, and markers for heart disease.

Research published in a 2018 journal article found that having an ECG as early as possible after palpitations begin can be critical in diagnosing arrhythmias before they become a serious condition.

Keep in mind that an ECG is just a “snapshot” of your heart at that time and may not reflect what your heart is doing during the arrhythmia or when you are having the palpitations.

Treatment for your heart palpitations will depend on their cause. Arrhythmias are sometimes treated with medications. In more serious cases, devices like a pacemaker may be implanted in your chest to regulate your heart rhythm.

Heart palpitations can affect anyone. They can be harmless changes in your heart rate due to exercise, stress, caffeine, or other factors.

However, heart palpitations can also be a sign of serious anxiety or underlying heart problem.

Knowing when to seek a medical evaluation for heart palpitations can help you get the diagnosis and treatment you need. Making other changes — such as cutting back on caffeine or learning stress management techniques — may also help calm your heart and give you peace of mind.

(Video) What causes heart palpitations and when should you see a heart specialist


When should heart palpitations be of concern? ›

Your palpitations are very frequent (more than 6 per minute or in groups of 3 or more) Your pulse is higher than 100 beats per minute (without other causes such as exercise or fever) You have risk factors for heart disease, including high cholesterol, high blood pressure, or diabetes.

How long is too long for heart palpitations? ›

Sustained heart palpitations lasting more than 30 seconds are considered a medical emergency. They could indicate pre-existing heart diseases such as coronary artery disease or heart valve disorders.

When should I talk to my doctor about heart palpitations? ›

Call 911 or go to the emergency room if heart palpitations occur with chest pain, severe shortness of breath, severe dizziness, excessive sweating or fainting. A change in lifestyle may help you control your heart palpitations: Try meditation or yoga to reduce stress and anxiety.

Is it normal to have heart palpitations all day? ›

Palpitations can happen at any time, even if you're resting or doing normal activities. Although they may be startling, palpitations usually aren't serious or harmful. However, they can sometimes be related to an abnormal heart rhythm that needs medical attention.

Is it normal to have heart palpitations every day? ›

Palpitations can be a sign of a heart problem. This is more likely in men or people with heart disease. If your palpitations are frequent, worsening, or lasting more than five minutes, speak with your doctor about your symptoms.

Do palpitations damage the heart? ›

What are the health risks of experiencing heart palpitations? The irregularity of the heart rhythm per se usually does no damage to the heart itself. Patients with a very rapid heart over a long period of time do run a risk of developing enlargement and failure of the heart.

How often is it normal to have heart palpitations? ›

These sensations are called heart palpitations. For most people, heart palpitations are a once-in-a-blue-moon occurrence. Others have dozens of these heart flutters a day, sometimes so strong that they feel like a heart attack. Most palpitations are caused by a harmless hiccup in the heart's rhythm.

What happens if heart palpitations go untreated? ›

If not treated, arrhythmias can damage the heart, brain, or other organs. This can lead to life-threatening stroke, heart failure, or cardiac arrest. During cardiac arrest, the heart suddenly and unexpectedly stops beating, causing death if it is not treated within minutes.

Why are my palpitations not stopping? ›

Sometimes heart palpitations can be a sign you're going through the menopause. Some people get them during pregnancy. Less often, they can be caused by a condition such as iron deficiency anaemia, an overactive thyroid (hyperthyroidism) or a heart rhythm problem (arrhythmia).

How can I calm my palpitations? ›

Try these tips to stop heart palpitations:

Splash cold water on your face, which stimulates a nerve that manages your heart rate. Breathe deeply to help your body relax. Vigorously move to stop palpitations through exercise. Reduce anxiety in whatever way works best for your unique needs.

Can you survive heart palpitations? ›

Many people live a normal life with palpitations, but some people may need some help to learn how to live with them. This may be talking therapies to help manage any anxiety the palpitations cause, or sometimes medication may be prescribed if the palpitations are interfering with you living a normal life.

Should I get my palpitations checked out? ›

Palpitations might feel alarming but keep in mind that in most cases they aren't a sign of any problems with your heart. However, you should always get palpitation symptoms checked out with your GP or health professional. You may sometimes feel that your heart skips a beat or there is an extra beat.

Should I go emergency for palpitations? ›

Changes to your heartbeat are usually not serious. But always see your doctor if you have palpitations or feel you have an irregular heart beat. Dial triple zero (000) if you have heart palpitations along with these symptoms: severe shortness of breath.

What will the hospital do for heart palpitations? ›

If a patient comes into the emergency department while the palpitations are going on, we may be able to provide medications to slow the heart rate or convert an abnormal heart rhythm to a normal one. In extreme cases where medications aren't enough, we may need to do a cardioversion.

What is the difference between heart palpitations and arrhythmia? ›

An arrhythmia is an abnormal heart rhythm, where the heart beats irregularly, too fast or too slowly. A palpitation is a short-lived feeling of your heart racing, fluttering, thumping or pounding in your chest. An occasional palpitation that does not affect your general health is not usually something to worry about.

What are the main causes of palpitations? ›

What causes palpitations?
  • Stress or anxiety.
  • Strenuous activity.
  • Extreme fatigue.
  • Hormonal changes caused by pregnancy, menopause or menstruation.
  • Low blood pressure.
  • Caffeine.
  • Nicotine.
  • Alcohol.

Will heart palpitations show up on an EKG? ›

Palpitations can be an early sign that there is something wrong with the heart. With palpitations, the first step is to capture the palpitations on ECG during an episode. Depending on what the rhythm is on the ECG, your doctor can often tell right away if the palpitations are something to worry about.

What is non cardiac palpitations? ›

Usually, palpitations are either related to your heart or the cause is unknown. Non-heart-related causes include: Strong emotions like anxiety, fear, or stress. They often happen during panic attacks. Vigorous physical activity.

What do anxiety heart palpitations feel like? ›

Heart Palpitations and Anxiety. Heart palpitations due to anxiety feel like your heart is racing, fluttering, pounding or skipping a beat. Your heartbeat can increase in response to specific stressful situations. You may also have palpitations due to an anxiety disorder (excessive or persistent worry).

Can drinking water stop heart palpitations? ›

Drink enough water

Dehydration can cause heart palpitations. That's because your blood contains water, so when you become dehydrated, your blood can become thicker. The thicker your blood is, the harder your heart has to work to move it through your veins.

Is it OK to sleep with palpitations? ›

If you have frequent heart palpitations when resting or lying down, you should schedule a visit with your provider. Most of the time, heart palpitations at night aren't harmful. But it's important to see your provider to be sure they aren't signs of a serious health problem.

How should I lay if I have heart palpitations? ›

This is because the heart is on the left side of the chest and when lying on the left side the heart is closer to the chest wall. This physical closeness makes skipped and therefore skipped beats may be easier to feel. If you notice heart palpitation when lying down, try lying on your right side to see if this helps.

How can I check my heart palpitations at home? ›

To check your pulse, place the second and third fingers of your right hand on the edge of your left wrist. Slide your fingers to the center of your wrist until you find your pulse. While taking your pulse, it's important to remember that you're checking your heart rhythm, not your heart rate.


1. Heart Palpitations: When Is It Serious?
2. Heart Palpitations — The Urgency Room — an educational care video
(The Urgency Room)
3. When To Seek Treatment for Heart Palpitations
(Medical Centric)
4. When to Take Palpitations Seriously and Visit the Doctor? | Dr. Vivek Chaturvedi
(Narayana Health)
5. Living with Arrhythmias: What to Know When Your Heart is Out of Rhythm
(Alliance for Aging Research)
6. Palpitations: When Should You Worry?
(Cardiology Made Easy)
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