Heart Palpitations: Causes and Treatment

In some cases, heart palpitations may indicate a more serious medical condition such as atrial fibrillation.

In some cases, heart palpitations may indicate a more serious medical condition such as atrial fibrillation.

What you need to know:

  • Heart palpitations can be caused by a variety of factors, some benign and some more serious.
  • In many cases, lifestyle changes and medications can help control or eliminate heart palpitations.
  • It is important to talk with your health care provider about any concerns you have and seek immediate medical attention if you experience associated symptoms such as fainting.

Do you have a racing heart? Does your heart feel like it is pounding out of your chest? You may be experiencing heart palpitations. Heart palpitations are described as a fluttering in the chest, rapid heartbeat, or feeling like your heart has skipped a beat.

They can be caused by anxiety and stress but may point to an underlying medical condition. Work with your health care provider to determine the potential causes for your symptoms.

Major triggers of heart palpitation

  • Consuming caffeine, alcohol, or smoking
  • Fever
  • Hormonal changes during pregnancy, menopause, or the menstrual cycle
  • Electrolyte imbalance from dehydration or excess sodium intake
  • Heart disease: heart attack, valve disease, congenital heart defects
  • Taking medication such as beta-blockers, thyroid medications, and aspirin
  • Extreme emotions such as fear or fury and stress.
  • Exercising strenuously
  • Low blood pressure

Signs and symptoms of heart palpitations

  • Racing heart
  • Chest pain or discomfort
  • Shortness of breath
  • Dizziness
  • Fainting

Patients may feel the pulse at night when sleeping or resting.

Diagnosis and treatment

Patients experiencing palpitation may undergo a medical history review to determine the causes of their symptoms. Your doctor will also conduct a physical exam to check your heart rate and rhythm blood pressure to evaluate any signs of poor circulation. Tests include:

  • Electrocardiogram (ECG) This test will evaluate the structure and function of your heart. It uses high-frequency sound waves to create an image of the heart.
  • Implantable loop recorder This is inserted under the skin and monitors your heartbeat for up to three years.
  • Stress test or exercise ECG This test measures how your heart responds to physical activity.
  • An event monitor is worn for some time if you have infrequent palpitation episodes. It records your heart's electrical activity while you are having an episode of palpitation.
  • Holter monitor continuously records your heart's electrical activity over a 24- or 72-hour period.

Treatment for heart palpitations will vary depending on the cause.

If anxiety and stress are the culprits, lifestyle changes such as exercise, relaxation techniques, and dietary modifications may be recommended to improve your heart health.

If a medical condition is causing your symptoms, treatment will be directed at the underlying cause of the palpitation.

In some cases, medication may be needed to control or slow down your heart rate and rhythm, reducing the severity of palpitations.

Drinking more water and limiting your intake of caffeine and alcohol may reduce vibrations.

Make sure to talk with your health care provider about any medication side effects you are experiencing.


In some cases, heart palpitations may indicate a more serious medical condition such as atrial fibrillation.

  • Cardiac arrest –  Your heart may beat so fast that it cannot pump blood effectively. This is a life-threatening emergency, and you may pass out or go into cardiac arrest.
  • Stroke –  Atrial fibrillation (irregular, rapid heartbeats) increases your risk of stroke. During atrial fibrillation, the blood in the upper chambers of your heart does not move as it should. This blood may form clots and move to your brain, causing a stroke.
  • Fainting –  Blood pressure can drop suddenly when the heart races, causing you to faint.
  • Heart failure –  If atrial fibrillation continues over time, it can weaken the heart muscle and lead to heart failure. Heart failure is a severe condition that means your heart does not pump enough blood through your body, which causes you to feel tired and weak.

If you experience any of these symptoms, seek immediate medical attention.