Understanding Heart Palpitations

Cross section of heart showing conduction system.

Heart palpitations are a symptom. It’s the feeling you have when your heartbeat seems to be racing, pounding, skipping, or fluttering. Heart palpitations are most often felt in the chest. Sometimes, they may also be felt in the neck.

What causes heart palpitations?

In most cases, heart palpitations are caused by:

  • Stress or anxiety

  • Exercise

  • Pregnancy

  • Some medicines

  • Caffeine

  • Nicotine

  • Alcohol

  • Illegal drugs, such as cocaine

  • Health problems, such as anemia or overactive thyroid

In some cases, heart palpitations may be caused by a problem with the heart. Abnormal heart rhythms (arrhythmias) are the main concern. They may need to be managed by you and your healthcare provider or treated right away.

How are heart palpitations treated?

Treatments for heart palpitations depend on the cause. Options may include:

  • Managing the things that trigger your heart palpitations. This could mean:

    • Learning ways to reduce stress and anxiety

    • Avoiding caffeine, nicotine, alcohol, or illegal drugs

    • Stopping the use of certain medicines, under your doctor’s guidance

  • Medicines, procedures, or surgery to treat an arrhythmia or other health problem that is causing your symptoms

What are the complications of heart palpitations?

Complications of heart palpitations are rare unless they are caused by a problem such as an arrhythmia. In such cases, complications can include:

  • Fainting

  • Heart failure. This problem occurs when the heart is so weak it no longer pumps blood well.

  • Blood clots and stroke

  • Sudden cardiac arrest. This problem occurs when the heart suddenly stops beating.

When should I call my healthcare provider?

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher, or as directed

  • Symptoms that don’t get better with treatment, or symptoms that get worse

  • New symptoms, such as chest pain, shortness of breath, dizziness, or fainting