Overview
Palpitations are an unusual awareness of your heartbeat. You may notice your heart beating too fast, too hard, unevenly, or as if it is skipping beats. They can happen during activity or at rest, and they may last seconds or longer. While many episodes are linked to common triggers, some can be related to heart, thyroid, blood, or other health problems.
Key Symptoms
People describe palpitations in different ways, including fluttering in the chest, pounding in the neck, a racing heart, or a flip-flop feeling. They may come with dizziness, lightheadedness, sweating, anxiety, shortness of breath, or weakness. Some people have no other symptoms, while others feel unwell during an episode.
Causes and Risk Factors
Common triggers include emotional stress, panic, strenuous exercise, lack of sleep, dehydration, fever, caffeine, nicotine, alcohol, and stimulant drugs. Some medicines and supplements can also trigger palpitations, including certain cold remedies, inhalers, and weight-loss products. Medical causes can include irregular heart rhythms, thyroid problems, low blood sugar, low oxygen levels, anemia, and hormonal changes such as pregnancy or menopause.
Who Is Affected
Palpitations can affect people of any age. They are more likely in people with anxiety, high caffeine or alcohol use, smoking, stimulant use, pregnancy, thyroid disease, anemia, or known heart disease. People who already have an irregular heartbeat or structural heart condition may have a higher chance of a serious cause.
Prevention
It may help to notice and avoid personal triggers such as energy drinks, nicotine, alcohol, or poor sleep. Managing stress, staying hydrated, and following care for conditions like thyroid disease can also reduce episodes for some people. Do not stop prescribed medicines on your own, but ask a healthcare professional if you think a medicine may be involved.
Diagnosis and Tests
A healthcare professional will usually ask what the sensation feels like, when it happens, how long it lasts, and what other symptoms occur with it. They may check your pulse, blood pressure, and heart, and may order tests such as an electrocardiogram (ECG), blood tests, or a wearable heart monitor. If symptoms happen during exercise or there is concern about heart disease, additional heart testing may be considered.
Treatment Categories
Treatment depends on the cause. Care may focus on removing triggers, treating an underlying condition such as thyroid disease or anemia, or evaluating and managing a heart rhythm problem. If a medicine, supplement, or stimulant is involved, a clinician may recommend changes after reviewing your situation.
When to Seek Medical Care
Arrange medical care if palpitations are new, happen often, last longer than usual, or interfere with daily life. You should also seek care if they occur during exercise, or if you have a history of heart disease, thyroid disease, fainting, stroke, or a family history of sudden cardiac death. Keeping a note of when episodes happen and what you were doing can help with evaluation.
When It May Be an Emergency
Get urgent medical help right away if palpitations happen with chest pain, fainting, severe shortness of breath, confusion, new weakness, or if you feel very unwell. Emergency care is also important if the heartbeat is very fast or very irregular and does not settle, especially in someone with known heart disease. These symptoms can signal a serious heart rhythm problem or another medical emergency.