Heart Palpitations: Causes, Symptoms, Treatment and When to Worry

Published: 18 June 2026 | Bhavesh Roy

Introduction

Have you ever noticed your heart beating unusually fast while sitting quietly, fluttering after drinking coffee, or pounding during a stressful situation? These sensations are commonly described as heart palpitations.

Palpitations can feel uncomfortable or alarming, especially when they occur unexpectedly. Some people notice an occasional extra or skipped beat, while others describe a racing heartbeat lasting several minutes. The experience varies from person to person.

Palpitations are a symptom, not a diagnosis. They may occur with a normal heart rhythm, an occasional extra beat, or an abnormal rhythm known as an arrhythmia. They may also be associated with non-cardiac conditions such as anaemia, thyroid disorders, fever or medication effects.

The important question is not simply whether you can feel your heartbeat, but what may be causing the sensation and whether other symptoms or medical conditions make further evaluation necessary.

This article explains what palpitations feel like, their possible causes, warning signs, diagnostic tests, treatment approaches and practical steps that may help reduce avoidable triggers.

Table of Contents

• What Are Heart Palpitations?
• Common Symptoms of Heart Palpitations
• Causes of Heart Palpitations
• Risk Factors for Heart Palpitations
• When Should You Worry About Heart Palpitations?
• How Are Heart Palpitations Diagnosed?
• Treatment Options for Heart Palpitations
• Home Care and Prevention Tips
• Heart Palpitations During Pregnancy
• Heart Palpitations vs. Arrhythmia
• Frequently Asked Questions (FAQs)
• Key Takeaways

1. What Are Heart Palpitations?

Heart palpitations are an increased awareness of the heartbeat. You might feel your heart racing, pounding, fluttering, beating irregularly or appearing to skip a beat. The sensation may be felt in the chest, throat or neck and can occur during physical activity, emotional stress or rest.

Why do palpitations occur?

The heart has an electrical conduction system that coordinates the timing of each heartbeat. Changes in heart rate, an extra heartbeat, an abnormal rhythm or increased awareness of otherwise normal beats can all produce the sensation of palpitations.

For example, a premature heartbeat may be followed by a brief pause and then a stronger beat. A person may perceive this as a skipped beat, even though the heart has not literally stopped. In other cases, a rhythm disturbance may cause the heart to beat rapidly or irregularly for a period of time.

Palpitations can also occur when the heart rhythm is normal. Stress, heightened awareness of the heartbeat and certain physical sensations may make otherwise ordinary beats more noticeable.

How long do palpitations last?

Some episodes last only a few seconds. Others can continue for minutes or longer, depending on the cause. Duration alone cannot determine whether an episode is harmless or serious.

Note when the sensation starts and stops, how frequently it occurs and whether it is accompanied by other symptoms. Recurrent, prolonged or changing episodes deserve medical assessment, even if previous episodes resolved without treatment.

Do palpitations always indicate heart disease?

No. Palpitations can occur without structural heart disease or a dangerous rhythm disorder. However, they can also be a symptom of arrhythmias or other medical conditions. The likelihood of a serious cause depends on factors such as the nature of the episodes, associated symptoms, medical history, examination findings and ECG results.

2. Common Symptoms of Heart Palpitations

People describe palpitations in different ways. Common sensations include:

• Fluttering: A fluttering or vibrating sensation in the chest.
• Racing heartbeat: A sensation that the heart is beating unusually quickly.
• Pounding heartbeat: Strong or forceful beats that are difficult to ignore.
• Skipped or extra beats: A sensation of a missed beat followed by a stronger beat.
• Irregular heartbeat: Beats that seem uneven or unpredictable.
• Pounding in the neck: A noticeable pulsing sensation around the throat or neck.

Palpitations may occur with or without other symptoms. Some people have no additional symptoms, while others may experience breathlessness, fatigue, dizziness or chest discomfort.

What should you record during an episode?

When it is safe to do so, keeping a record may help your healthcare professional understand the pattern. Consider noting:

• Whether the heartbeat changed suddenly or gradually.
• What you were doing when it began, such as resting, exercising or feeling stressed.
• Approximately how long the episode lasted and how often it occurs.
• Whether you had chest discomfort, breathlessness, dizziness or near-fainting.
• Recent caffeine, nicotine, alcohol, medicines or supplements that might be relevant.

Do not delay emergency care to record symptoms, check your pulse or use a wearable device. If an episode causes concerning symptoms, seek medical attention promptly.

3. Causes of Heart Palpitations

Palpitations have many possible causes. Some relate to everyday habits, while others are associated with medication effects, medical conditions or a heart rhythm disorder.

Stress and anxiety

Stress can activate the body’s fight-or-flight response, increasing the release of stress hormones and making the heartbeat faster or more forceful. Anxiety may also increase awareness of normal bodily sensations.

Sometimes palpitations lead to further anxiety, which can make the sensations more noticeable. However, anxiety should not automatically be assumed to be the cause of unexplained or recurrent palpitations. Medical causes may need to be considered, particularly when symptoms are new, persistent or associated with warning signs.

Can caffeine cause palpitations?

Caffeine can trigger palpitations in some people, particularly when consumed in large amounts or through concentrated sources such as energy drinks and certain workout supplements. Sensitivity varies between individuals, and the effect may also depend on medication use and underlying health conditions.

If you suspect a connection, consider recording your intake and discussing a reduction with a healthcare professional. Avoid assuming that caffeine is the only cause if episodes continue.

Dehydration, illness and metabolic conditions

Dehydration, fever, anaemia, low blood sugar and electrolyte disturbances can affect heart rate or contribute to palpitations. An overactive thyroid can also cause a rapid heartbeat. Identifying and treating the underlying issue may reduce symptoms.

Hydration needs vary. A person with kidney disease, heart failure or a prescribed fluid restriction should not increase fluid intake substantially without medical advice.

Medication and supplement effects

Some medicines can cause palpitations or influence heart rate. Examples may include certain decongestants, bronchodilator inhalers, thyroid medicines and stimulant-containing products. The effect depends on the medicine, dose, individual sensitivity and other conditions.

Do not discontinue prescribed medication on your own. If palpitations begin after starting a medicine or changing a dose, contact the prescriber or pharmacist for advice. Mention all over-the-counter medicines, supplements and substances you use.

Heart rhythm disorders

Arrhythmias are another possible cause. Some are relatively benign, while others may require treatment or monitoring. Examples include atrial fibrillation, supraventricular tachycardia and certain ventricular rhythm disorders.

The sensation of palpitations cannot identify which rhythm is present. A rhythm recording during symptoms, when available, can help a clinician determine whether an arrhythmia is responsible.

4. Risk Factors for Heart Palpitations

Anyone may experience palpitations. Some factors, however, increase the likelihood that the symptom is associated with an underlying condition that needs assessment.

• Existing heart disease: A history of arrhythmia, heart attack, heart failure, valve disease or another cardiac condition may change the significance of palpitations.
• Family history: A family history of inherited heart rhythm disorders, unexplained fainting or sudden cardiac death at a young age is important to mention to a clinician.
• Thyroid disorders: An overactive thyroid may increase heart rate and contribute to rhythm problems.
• Anaemia or electrolyte disturbances: These conditions may cause or contribute to palpitations.
• Medication and substance use: Certain prescription medicines, stimulants, nicotine, alcohol and recreational drugs may trigger symptoms.
• Pregnancy: Normal changes in circulation and heart rate may make the heartbeat more noticeable, although other causes can also occur.
• Sleep deprivation and stress: These can contribute to symptoms or make the heartbeat more noticeable.

High blood pressure, diabetes, age and other cardiovascular risk factors may be relevant to the overall assessment, but they do not mean that every episode of palpitations represents a dangerous arrhythmia.

5. When Should You Worry About Heart Palpitations?

Brief palpitations without other symptoms are often not caused by a serious condition. Nevertheless, it is not possible to classify an episode as harmless based only on how it feels or how long it lasts.

When to seek emergency medical care

Seek emergency medical help if palpitations are happening now and are accompanied by any of the following:

• Chest pain, pressure or tightness.
• Severe or sudden shortness of breath.
• Fainting or feeling as though you may faint.
• Collapse, severe weakness or significant deterioration in your condition.
• Other symptoms that suggest a possible heart attack or serious medical emergency.

Do not wait for the symptoms to reach a particular duration or assume that the problem will settle by itself. In India, dial 112 for emergency assistance. Do not drive yourself to hospital if you may be experiencing a medical emergency.

If concerning symptoms have stopped by the time you seek advice, you may still need urgent assessment. Temporary improvement does not rule out a significant rhythm problem or another serious condition.

When to arrange a medical appointment

Arrange a clinical assessment if palpitations:

• Keep returning, become more frequent or last longer than usual.
• Start interfering with your usual activities or sleep.
• Occur with recurring dizziness or unusual breathlessness, even if these symptoms are not severe.
• Begin after a change in medication or supplement use.
• Occur in someone with known heart disease or a relevant family history.

There is no single duration that separates harmless from dangerous palpitations. Their context, accompanying symptoms and the person’s health history matter.

Does dizziness always mean an emergency?

Dizziness has many causes. Mild, brief dizziness does not necessarily indicate a dangerous arrhythmia, but dizziness associated with palpitations deserves attention. Fainting, near-fainting, severe breathlessness or chest pain calls for emergency assessment.

6. How Are Heart Palpitations Diagnosed?

The aim of evaluation is to determine what may be causing the sensation and whether there is an underlying heart rhythm disorder or another medical condition. The tests recommended depend on your symptoms, medical history, physical examination and initial findings.

Medical history and examination

A clinician may ask when the episodes began, how often they occur, whether they start and stop suddenly, what seems to trigger them and whether symptoms such as breathlessness or dizziness occur at the same time. Information about medicines, caffeine, other substances, existing conditions and family history may also be relevant.

The examination may include checking your pulse and blood pressure and listening to your heart. The clinician may also look for signs of anaemia, thyroid disease or other conditions, depending on the circumstances.

Electrocardiogram (ECG)

An ECG records the electrical activity of the heart over a short period. It can identify certain rhythm abnormalities and conduction problems, and it may provide clues about other cardiac conditions.

An ECG performed between episodes may be normal even when a person has intermittent palpitations. A normal resting ECG therefore does not always exclude an episodic arrhythmia.

Holter and other ambulatory rhythm monitors

Portable ECG devices record the heart’s rhythm during usual daily activities. The appropriate device depends partly on how often symptoms occur.

• Holter monitor: Records the heart rhythm continuously, often for one or two days, although monitoring duration may vary.
• Patch monitor: A wearable device that may record the rhythm for several days or longer, depending on the device.
• Event monitor: Records or saves rhythm information around symptoms during a longer monitoring period, according to the device’s design.
• Other monitoring: Longer-term or implantable monitors may be considered in selected cases, particularly when important episodes are infrequent and remain unexplained.

Recording the rhythm during an episode may help establish whether the sensation corresponds to an arrhythmia. Wearables may provide useful information, but they do not replace clinical assessment, and their readings can be inaccurate or incomplete.

Blood tests

Targeted blood tests may be used to look for conditions that can contribute to palpitations. Depending on the clinical assessment, these may include a complete blood count for anaemia, thyroid function tests, electrolyte measurements or blood glucose testing.

Not everyone requires every test. The clinician selects investigations based on symptoms, medical history and examination findings.

Echocardiogram

An echocardiogram uses ultrasound to assess heart structure, pumping function and valve function. It may be appropriate when the history, examination or ECG raises concern about structural heart disease. It is not automatically required for every person with palpitations.

Exercise testing and other investigations

An exercise stress test may be considered when palpitations are related to exertion or when there is concern about coronary artery disease or exercise-related rhythm changes. Other investigations may be appropriate in selected cases.

The purpose of testing is not to perform every available investigation, but to choose tests that help answer the clinical questions raised by the person’s symptoms and risk factors.

7. Treatment Options for Heart Palpitations

Palpitations do not have one universal treatment. Management depends on whether a specific cause is identified, whether a rhythm disorder is present and how much the symptoms affect the person.

Lifestyle changes

When a trigger is identified, adjusting caffeine intake, avoiding nicotine, improving sleep or reducing alcohol consumption may help. If dehydration contributes, correcting it may also be useful, provided the person does not have a medical reason to restrict fluids.

Medication

Some people with a confirmed rhythm disorder may benefit from medicines that control heart rate or rhythm. The choice depends on the specific diagnosis, other conditions and possible side effects. Certain medicines are unsuitable for some arrhythmias or for people with particular medical histories.

Do not take another person’s heart medication or begin a beta-blocker or anti-arrhythmic medicine without a prescription. Do not stop prescribed medicines without medical guidance.

Catheter ablation and devices

Catheter ablation uses specialised catheters to treat the tissue responsible for certain abnormal electrical pathways or rhythm circuits. It may be appropriate for selected arrhythmias when symptoms, risks and expected benefits support the procedure.

A pacemaker is used for particular problems involving an excessively slow heart rate or electrical conduction. It is not a routine treatment for palpitations themselves. Other devices may be appropriate for specific rhythm conditions, depending on the diagnosis.

Many people with palpitations do not need an invasive procedure. Treatment should follow a confirmed or sufficiently well-supported clinical diagnosis.

8. Home Care and Prevention Tips

If a healthcare professional has assessed your symptoms and found no condition requiring specific treatment, certain practical steps may help reduce triggers.

• Review caffeine intake: Consider reducing coffee, energy drinks or other caffeinated products if a clear association with symptoms is present.
• Maintain appropriate hydration: Drink fluids regularly according to your health needs. Follow any fluid restrictions given for heart or kidney conditions.
• Prioritise sleep: Keep a regular sleep schedule and seek advice if persistent sleep problems are affecting your daily life.
• Avoid nicotine: Smoking and other nicotine products can affect cardiovascular function. Seek cessation support if needed.
• Limit or avoid alcohol if it triggers symptoms: Individual sensitivity varies, and alcohol can contribute to palpitations in some people.
• Manage stress: Relaxation techniques, gentle breathing exercises or appropriate psychological support may help when stress contributes to symptoms.
• Review medicines and supplements: Ask a clinician or pharmacist whether a product could be contributing to palpitations.
• Exercise appropriately: Regular physical activity can benefit general cardiovascular health. However, new palpitations during exercise, especially with chest pain, breathlessness or dizziness, need medical assessment.

These measures are not substitutes for evaluation of unexplained or worsening symptoms. Avoid using home remedies, breathing techniques or additional medication to delay emergency care when warning signs are present.

9. Heart Palpitations During Pregnancy

Some pregnant people notice that their heart beats faster or feels more forceful. Pregnancy brings changes in blood volume, circulation and the workload placed on the heart, so the heartbeat may become more noticeable.

However, palpitations during pregnancy should not automatically be attributed to normal changes. Anaemia, thyroid conditions, dehydration, medication effects and heart rhythm disorders can also occur during pregnancy.

When should you seek advice?

Mention new, recurrent or persistent palpitations to your midwife, obstetrician or other healthcare professional. They can assess whether observation is sufficient or whether an ECG, blood tests, rhythm monitoring or another investigation is appropriate.

Seek emergency medical care if palpitations occur with chest pain, severe or sudden breathlessness, fainting or near-fainting, or other signs of a medical emergency. Do not delay assessment because you are pregnant or assume the symptoms are only hormonal.

What about treatment during pregnancy?

Treatment depends on the cause and the severity of symptoms. Decisions about medicines or procedures should take pregnancy and the health of both the pregnant person and baby into account. Do not start, stop or change medication without advice from the treating healthcare team.

People who experience palpitations after delivery should also seek assessment if the episodes are persistent, worsening or accompanied by concerning symptoms.

10. Heart Palpitations vs. Arrhythmia

Palpitations and arrhythmia are related terms, but they do not mean the same thing.

A person can experience palpitations without having an arrhythmia, and some arrhythmias can occur without noticeable symptoms. This is why a description of the sensation alone cannot establish a rhythm diagnosis.

11. Frequently Asked Questions (FAQs)

1. What are heart palpitations?

Heart palpitations are sensations in which a person becomes unusually aware of their heartbeat, such as feeling racing, pounding, fluttering, irregular or skipped beats. They are a symptom rather than a diagnosis.

2. What causes heart palpitations?

Possible causes include stress, lack of sleep, caffeine, nicotine, alcohol, dehydration, certain medicines, anaemia, thyroid disorders and heart rhythm problems. The cause depends on the individual and may require clinical assessment.

3. Are heart palpitations dangerous?

Many episodes are not caused by a serious condition, but some are associated with arrhythmias or other medical problems. Palpitations with chest pain, severe breathlessness, fainting or near-fainting require emergency assessment.

4. When should I worry about heart palpitations?

Seek emergency help when palpitations occur with chest pain or pressure, severe or sudden shortness of breath, fainting, near-fainting or collapse. Arrange a medical assessment for recurrent, prolonged or worsening episodes, particularly if you have known heart disease or a relevant family history.

5. Can anxiety cause heart palpitations?

Yes. Stress and anxiety can increase heart rate and make the heartbeat more noticeable. However, unexplained or recurrent symptoms should not automatically be attributed to anxiety without considering other possible causes.

6. Can dehydration cause heart palpitations?

Dehydration may contribute to a faster heartbeat or palpitations. Correcting dehydration may help when it is the cause, but fluid needs vary. People with heart or kidney conditions and prescribed fluid restrictions should seek advice before increasing their intake.

7. How are heart palpitations diagnosed?

Evaluation may include a medical history, physical examination, ECG, ambulatory rhythm monitoring and targeted blood tests. An echocardiogram or exercise test may be appropriate in selected cases, depending on symptoms and the initial findings.

8. What is the best treatment for heart palpitations?

There is no single best treatment for everyone. Management may involve reducing a trigger, treating an underlying condition, prescribing medication for a confirmed rhythm problem or considering a procedure for selected arrhythmias. Some people do not need specific treatment.

9. Can heart palpitations go away on their own?

Some episodes resolve spontaneously, particularly when they are related to a temporary trigger. However, symptoms that recur, last longer than usual or change in pattern should not be ignored just because earlier episodes stopped without treatment.

10. Are heart palpitations a sign of a heart attack?

Palpitations alone do not establish that someone is having a heart attack. However, palpitations accompanied by chest discomfort, shortness of breath, cold sweating, faintness or other concerning symptoms require urgent assessment. Do not delay emergency care while trying to determine the cause at home.

11. Which foods trigger heart palpitations?

There is no single list of foods that triggers palpitations in everyone. Caffeine-containing drinks and concentrated stimulant products can contribute in some people, while other suspected triggers vary. A symptom and food diary may help identify patterns, but persistent symptoms need appropriate assessment.

12. Can caffeine cause heart palpitations?

Yes. Caffeine can cause palpitations in some people, particularly when intake is high or sensitivity is increased. If you notice a pattern, consider reducing caffeine and discussing persistent symptoms with a healthcare professional.

13. Are heart palpitations common during pregnancy?

Some people experience a more noticeable or faster heartbeat during pregnancy because circulation changes. However, palpitations can also have other causes. Mention recurrent or persistent episodes to your maternity care team, and seek emergency help for chest pain, severe breathlessness, fainting or near-fainting.

14. How long do heart palpitations last?

Episodes may last seconds, minutes or longer, depending on their cause. Duration alone cannot determine whether an episode is harmless. Seek assessment for prolonged, recurrent or worsening symptoms and emergency care when warning signs occur.

15. Which doctor should I see for heart palpitations?

A primary care doctor or other qualified healthcare professional can begin the assessment and refer you to a cardiologist when appropriate. A heart rhythm specialist may be involved for selected diagnosed arrhythmias. Emergency symptoms should be assessed through emergency services rather than waiting for a routine appointment.

12. Key Takeaways

• Palpitations describe a sensation of an unusual heartbeat; they do not automatically mean that an arrhythmia is present.
• Possible triggers include stress, caffeine, lack of sleep, dehydration, medication effects and certain medical conditions.
• Chest pain, severe or sudden shortness of breath, fainting or near-fainting with palpitations requires emergency assessment.
• Recurrent, prolonged or worsening episodes should be assessed, especially in people with known heart disease or a relevant family history.
• ECGs, ambulatory rhythm monitors and targeted blood tests may help identify the cause. Other tests depend on the clinical findings.
• Treatment depends on the underlying cause. Medication or a procedure is not required for every person with palpitations.
• Lifestyle adjustments may help when a trigger is identified, but they should not replace medical assessment when symptoms are unexplained or concerning.
• Palpitations during pregnancy should be discussed with the maternity care team if they are new, recurrent or persistent.

Conclusion

Heart palpitations can feel unsettling, but the sensation alone does not reveal whether the heart rhythm is normal or abnormal. Triggers such as stress, caffeine, lack of sleep and certain medicines may contribute, while some episodes are associated with medical conditions that need investigation.

Paying attention to the pattern of symptoms, identifying possible triggers and arranging appropriate medical assessment can help determine the next steps. Testing should be selected according to the person’s symptoms, medical history and examination findings.

Most importantly, do not dismiss palpitations accompanied by chest pain, severe breathlessness, fainting or near-fainting. These symptoms require emergency medical attention. For recurrent or changing episodes, seek clinical advice rather than relying on home remedies or assuming the cause is anxiety.