Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion.

If you’ve ever felt like your heart was racing or pounding, you may have experienced heart palpitations. This fluttering can be the result of an abnormal heart rhythm causing the misfiring of an electrical signal in the heart that makes it beat out of rhythm.

Palpitations can sometimes be frightful, especially if you have never experienced them. Fortunately, palpitations often are not a cause for concern. They most commonly occur at rest. Still, you should never ignore them, especially if you are at high risk of heart disease, as palpitations on rare occasions may be a sign of a more serious problem like valvular heart disease or hyperthyroidism (overactive thyroid). 

This article discusses the symptoms and potential causes of palpitations and highlights the significant risk factors you need to be aware of.

Some people have palpitations every once in a while, while others have them more regularly. People experience different palpitation sensations but they typically are described as:

The symptoms of nausea, shortness of breath, or sweating may also accompany your palpitations.

Palpitations—if associated with low blood pressure or heart failure—can sometimes also cause you to feel faint or light-headed.

Palpitations are commonly triggered by fear, anxiety or stress, strenuous exercise, or consuming too much caffeine, but sometimes the cause is unknown. They usually go away on their own without any treatment and people learn to live with this abnormal heart rhythm. 

The most common causes of palpitations are:

As previously mentioned, some recreational drugs like cocaine and amphetamines can cause heart palpitations. Others like pseudoephedrine have become tightly regulated since they have been shown to increase heart failure risk in vulnerable populations.

It’s important to know which medications can trigger palpitations so that you know this connection should you experience this symptom. 

The following medicines can occasionally trigger palpitations:

It is always recommended that you consult your healthcare provider before reducing or stopping a prescribed medication. Never stop taking a prescribed treatment without first getting medical advice even if you believe that your medication is the cause of your heart palpitations.

The specific treatment for your palpitations will depend on the cause of your symptoms. Most of the time, palpitations will go away on their own or may be resolved by doing the following:

If the cause of your heart palpitations is due to thyroid problems, arrhythmias, atrial fibrillation, or another heart condition such as heart failure or valvular heart disease, you may need to take medications, surgery, or a pacemaker to correct your abnormal heart rhythm.

Therefore, if you experience heart palpitations and are at high risk of heart problems it is suggested that you contact a medical professional as soon as possible. 

Most people don’t experience heart palpitations during a medical visit. Your healthcare provider will take a detailed history, asking you about your medications, lifestyle habits, and past medical history. They may also perform a focused physical exam, listening to your heart with a stethoscope for signs of an abnormal heartbeat or arrhythmia. 

To determine what might be causing your heart palpitations, your healthcare provider may recommend or perform one of the following tests:

Consult your healthcare provider if your test results are unclear or if you have any questions. After taking these exams you will likely meet with your healthcare provider who will explain the results and discuss your treatment options.

There are two general tools to diagnose the cause of palpitations:

Palpitations are usually not harmful, but they may be a cause for concern if they are associated with any of the following symptoms:  

Get immediate medical attention if you have any of the aforementioned symptoms or if your palpitations are new, persistent, or getting worse. 

Palpitations are a common symptom most often caused by a benign cardiac rhythm abnormality. They are usually harmless, but in rare cases, they may be a sign of a serious medical condition.

Palpitations are often not a cause for concern. However, it's best to let your healthcare provider know you are experiencing palpitations. Your provider can run tests to check for an underlying medical condition.

Palpitations are an abnormal heart rhythm reflective of the misfiring of an electrical signal in the heart, causing it to beat out of rhythm. Strong emotional responses (as a result of fear, anxiety, and stress), strenuous activity, high amounts of caffeine, and structural abnormalities of the heart are the most common triggers of palpitations.

Palpitations are not usually dangerous and are only rarely associated with heart failure.

If your palpitations occur once in a while, they may go away on their own or with simple home techniques. If your heart palpitations are due to more serious medical conditions you may need to take medication, have surgery, or use a pacemaker to help resolve your abnormal heart rhythm. 

Eating a heart-healthy diet, never smoking and limiting alcohol, avoiding foods that trigger your palpitations, and limiting stress are great ways to prevent palpitations.

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Oxford Medical Education. Differential diagnosis for palpitations.

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