Heart Palpitations and Anxiety: Causes, Symptoms, and How to Find Calm
Updated: 4 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
TL;DR
Heart palpitations, the feeling that your heart is racing, fluttering or pounding, are common and often harmless symptoms of anxiety. When you feel stressed, your body's "fight or flight" response activates the autonomic nervous system and speeds up your heart. Anxiety-related palpitations usually go away within a few minutes once the stress passes. [1] Persistent palpitations, or palpitations with chest pain, fainting or severe shortness of breath, need medical evaluation to rule out a heart condition.
Quick Answer
Heart palpitations from anxiety are common because stress activates the autonomic nervous system, speeding up and strengthening the heartbeat. Anxiety palpitations usually go away within a few minutes. Get emergency care if palpitations come with chest pain, fainting or severe shortness of breath. Cognitive behavioral therapy, relaxation techniques and, for some people, medicine can help. [1]
What the research says
Anxiety is behind a large share of palpitations, but heart causes must be ruled out. In a prospective study of 190 patients with palpitations, the cause was cardiac in 43%, psychiatric in 31%, miscellaneous in 10% and unknown in 16%. Forty percent of causes were found with history, exam, EKG and lab tests alone. One-year mortality was 1.6% and 75% had recurrent palpitations. (Weber & Kapoor, Am J Med, 1996)
CBT has the strongest evidence for anxiety disorders. A review of 106 meta-analyses (from 269 identified) found the strongest support for CBT in anxiety disorders, somatoform disorders, bulimia, anger control problems and general stress. (Hofmann et al., Cognit Ther Res, 2012)
What Are Heart Palpitations From Anxiety?
Heart palpitations are an uncomfortable awareness of your own heartbeat. You may feel your heart pounding against your ribs, fluttering in your chest or racing as if you had just run. You can feel it in the chest, neck or throat.
When anxiety is the cause, palpitations are usually not a sign of a damaged heart. They are a physical reaction to perceived danger. The autonomic nervous system (ANS), which controls involuntary functions such as breathing and heart rate, triggers the "fight or flight" response when you feel uneasy or threatened. Stress hormones then make the heart beat faster and more forcefully. [1]
Sensation | Description |
Fluttering | A flapping or "flipping" feeling in the chest. |
Pounding | A strong, forceful beat that you may feel in your neck or ears. |
Skipped beats | A feeling that the heart paused or missed a beat. |
Racing | A fast heartbeat that may start and stop suddenly. |
The Link Between Stress and Your Heart
Anxiety disorders are the most common mental health condition in the U.S., affecting almost 1 in 5 people at some point. [1] For many people, the physical symptoms are more upsetting than the emotional ones. Because palpitations feel so intense, it is common to worry about a heart attack.
Why the Heart Reacts to Anxiety
When something triggers anxiety, such as public speaking, a job interview or a flight, the ANS takes over. Besides palpitations, this response can cause:
Rapid, shallow breathing
Muscle tension and trembling
Heavy sweating
Digestive symptoms such as gas or diarrhea
Unlike palpitations from a structural heart problem, anxiety palpitations usually pass within minutes as the stressful situation resolves. [1]
When Should You Worry?
Most palpitations are harmless, but they can sometimes signal a more serious problem, such as an irregular heart rhythm (arrhythmia), thyroid problems or heart valve disease.
Emergency Red Flags
Get medical help right away if palpitations come with any of the following: [1]
Chest pain: Any pressure, tightness or discomfort in the chest.
Shortness of breath: Trouble catching your breath, especially at rest.
Fainting: Loss of consciousness or feeling that you may pass out.
Severe dizziness: Feeling very lightheaded or confused.
Swelling: New or worsening swelling in the legs, ankles or feet.
Diagnosis and Finding the Cause
To tell whether palpitations come from anxiety or a physical heart problem, a healthcare provider does a physical exam and reviews your medical history, lifestyle (including caffeine and alcohol) and medicines. In many people, the cause can be found with a simple first evaluation. (Weber & Kapoor, 1996)
Common Diagnostic Tests
Electrocardiogram (EKG/ECG): A quick test that records the heart's electrical activity. [1]
Holter monitor: A wearable device that records your heart rhythm for 24 to 48 hours. [1]
Echocardiogram: An ultrasound that checks the heart's structure and function. [1]
Blood tests: Check for anemia, thyroid problems and electrolyte problems such as low potassium. [1]
How to Stop Palpitations and Find Calm
If your doctor confirms that anxiety is the cause, treatment focuses on calming the stress response. It often combines therapy, lifestyle changes and sometimes medicine.
Professional Treatments
Psychotherapy: Cognitive behavioral therapy (CBT) helps you identify and change the thought patterns that trigger anxiety. [1] A review of meta-analyses found the strongest support for CBT in anxiety disorders. (Hofmann et al., 2012)
Medication: Antidepressants or anti-anxiety medicines (anxiolytics) can help some people, and beta-blockers may be prescribed in some cases. Your provider will choose what is right for you. [1]
Self-Care and Immediate Relief
Diaphragmatic breathing: Slow, deep belly breaths can help your nervous system calm down. [1]
Regular physical activity: Exercise helps reduce stress and anxiety. [1]
Meditation and mindfulness: Daily practice can lower your baseline level of anxiety.
Limiting triggers: Cutting back on caffeine and alcohol can reduce palpitations. [1]
Conclusion
Heart palpitations can be frightening, but when anxiety is the cause they are a manageable body response to stress. Knowing your triggers, practicing relaxation techniques and working with a healthcare provider can help you feel in control of your heartbeat again.
Looking for clear answers on tough health questions? Browse plain-language health guides at Rinnit.com.
Frequently Asked Questions
Can anxiety cause heart palpitations even when I do not feel stressed?
Yes. People with generalized anxiety disorder can have physical symptoms such as palpitations even when there is no obvious, immediate stressor.
How long do anxiety palpitations usually last?
Anxiety palpitations usually go away within a few minutes once the stressful situation passes. [1] If they last for hours or keep coming back, contact a healthcare provider.
Is it safe to exercise if I have palpitations?
If your doctor has confirmed that your palpitations are linked to anxiety and your heart is structurally healthy, regular physical activity is recommended to help manage stress. [1] Check with your doctor first if the cause is not yet known.
Can caffeine make anxiety palpitations worse?
Yes. Caffeine and alcohol can both cause palpitations, so cutting back may reduce them. [1]
Can I feel palpitations in my throat?
Yes. It is common to feel a racing or pounding heartbeat in the chest, neck or throat.
Are beta-blockers habit-forming?
Beta-blockers are not considered habit-forming, unlike benzodiazepines, but they should be taken only as prescribed. [1]
Can lack of sleep cause heart palpitations?
Sleep loss can make the nervous system more reactive and anxiety worse, which can bring on palpitations.
What is biofeedback?
Biofeedback is a technique in which sensors give you real-time information about body functions such as heart rate, so you can learn to influence them.
Can low potassium or other electrolyte problems cause palpitations?
Yes. Blood tests are used to check for low potassium and other problems such as anemia and thyroid disease that can cause palpitations. [1] Talk to your doctor before taking any supplement.
Can a panic attack feel like a heart attack?
Yes. The symptoms can overlap, including chest tightness, a racing heart and shortness of breath. If you are unsure, or have chest pain, get emergency care.
What is exposure therapy?
Exposure therapy is a form of therapy in which you are gradually and safely exposed to things that cause anxiety so you can build a calmer response over time.
Can herbal supplements cause palpitations?
Some can. Stimulant-containing supplements may raise heart rate or anxiety. Give your doctor a full list of everything you take.
Why does my heart seem to skip a beat when I am nervous?
Stress hormones can trigger an extra heartbeat, which feels like a pause followed by a stronger beat. It is often harmless, but report frequent episodes to your provider.
Is it normal to feel tired after palpitations?
Yes. The adrenaline surge during a stressful episode can leave you physically and emotionally drained afterward.
References
Cleveland Clinic. Heart Palpitations and Anxiety. Cleveland Clinic. Last updated August 12, 2024. https://my.clevelandclinic.org/health/diseases/21677-heart-palpitations-and-anxiety
Weber BE, et al. Evaluation and outcomes of patients with palpitations. Am J Med. 1996;100(2):138-148. PMID 8629647. https://doi.org/10.1016/s0002-9343(97)89451-x
Hofmann SG, et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012;36(5):427-440. PMID 23459093. https://doi.org/10.1007/s10608-012-9476-1
Medical disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have about a medical condition. Never disregard professional medical advice or delay seeking care because of something you have read here. If you think you may have a medical emergency, call your doctor or emergency services immediately.
Comments