Heart Palpitations: Causes, Symptoms, and When to Seek Help
Heart palpitations are the sensation that your heart is racing, skipping, fluttering, or pounding. Many people notice palpitations after exercise, caffeine, or during anxious moments; others feel them at rest. While palpitations are often harmless, they can sometimes signal an underlying heart rhythm issue or other medical condition. Understanding common triggers, symptoms, and when to get medical evaluation can help you respond appropriately and reduce unnecessary worry.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
What are heart palpitations?
Heart palpitations are the subjective feeling of irregular or forceful heartbeats. They result from changes in heart rate, rhythm, or the strength of contractions. Normal causes include premature beats (extrasystoles) or brief runs of a faster rhythm; more persistent palpitations may reflect arrhythmias such as atrial fibrillation or supraventricular tachycardia. Healthcare providers will usually ask about timing, triggers, associated symptoms (dizziness, shortness of breath), and medical history to determine the likely cause. Simple monitoring like an electrocardiogram (ECG) or longer-term patch or Holter monitor can often capture abnormal rhythms for diagnosis.
Why do palpitations cause chest sensations?
Palpitations are often felt in the chest because the heart sits behind the breastbone and transmits movement and pressure to nearby structures. A strong or skipped beat may be noticeable as a thump or flutter in the chest, throat, or neck. Sometimes palpitations coincide with chest tightness or mild discomfort, especially when associated with anxiety, gastroesophageal reflux, or muscle strain. However, any chest pain that is new, severe, or accompanied by shortness of breath, fainting, or sweating should be evaluated promptly to rule out heart-related emergencies such as ischemia or pericarditis.
How are palpitations linked to anxiety?
Anxiety commonly produces palpitations through activation of the sympathetic nervous system, which increases heart rate and contractility. Panic attacks and sustained anxiety disorders frequently present with sudden awareness of a racing heart, trembling, and breathlessness. In many people, the palpitations themselves then feed more anxiety, creating a cycle. Assessment typically includes ruling out physical causes—such as thyroid dysfunction or stimulant use—before attributing palpitations solely to anxiety. Behavioral therapies, breathing techniques, and, where appropriate, medication can reduce anxiety-related palpitations by lowering overall arousal and improving coping skills.
How can stress trigger palpitations?
Stress triggers the body’s “fight or flight” response, releasing adrenaline and other hormones that speed the heart and increase the force of contractions. Short-term stressors (work deadlines, acute worry) and long-term chronic stress (caregiving, prolonged pressure) can both increase the frequency of palpitations. Lifestyle factors that often accompany stress—poor sleep, increased caffeine or alcohol intake, dehydration, and skipped meals—can further raise the likelihood of palpitations. Practical measures such as regular physical activity, improved sleep hygiene, reducing stimulants, and structured relaxation practices (progressive muscle relaxation, mindfulness) can lower stress-related episodes.
When to seek medical help for palpitations?
Seek immediate medical attention if palpitations occur with fainting, near-fainting, severe shortness of breath, chest pain suggestive of angina, or sudden weakness—these may indicate serious conditions requiring urgent care. For palpitations that are frequent but not immediately dangerous, schedule evaluation with a primary care clinician or cardiologist. Typical outpatient assessment includes ECG, blood tests (electrolytes, thyroid function), and ambulatory monitoring (24–48 hour Holter or longer wearable devices) to document intermittent arrhythmias. Management depends on the cause and can range from reassurance and lifestyle changes to medications, catheter ablation for certain arrhythmias, or treatment of contributing medical issues.
Conclusion
Heart palpitations are a common symptom with a wide range of causes from benign premature beats to arrhythmias and responses to anxiety or stress. Careful history-taking, targeted tests, and attention to lifestyle factors often clarify the cause and guide appropriate management. When palpitations come with concerning symptoms such as fainting, severe chest pain, or breathing difficulty, prompt medical evaluation is important. Regular follow-up with a healthcare professional can help manage recurrent palpitations and address underlying contributors.
