Heart Palpitations: Causes, Symptoms & Treatment Guide

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026

Source currency note: This article is based on clinical information reviewed in March 2020; medical guidance changes over time, so always confirm details with your healthcare professional.

At a Glance

TL;DR: Heart palpitations — feelings of a fast-beating, fluttering or pounding heart — are usually harmless and often triggered by stress, exercise, stimulants or hormone changes. They are felt in the chest, throat or neck, during activity or at rest. Brief, infrequent episodes rarely need evaluation. But call emergency services if palpitations come with chest pain, fainting, severe shortness of breath or severe dizziness, and see your provider if palpitations are frequent or worsening and you have a history of heart disease.

Quick Answer:

• Heart palpitations are feelings of a fast-beating, fluttering or pounding heart, sometimes with skipped or flip-flopping beats.

• They are usually harmless, triggered by stress, exercise, medication or, rarely, a medical condition.

• Common causes include stress, anxiety, caffeine, nicotine, stimulants, fever, hormone changes and thyroid imbalances.

• Call emergency services if palpitations come with chest discomfort, fainting, severe shortness of breath or severe dizziness.

• Rarely, palpitations are a symptom of an irregular heartbeat (arrhythmia), which might require treatment.

• Diagnosis involves a physical exam and, if needed, an ECG/EKG, Holter monitor, event recorder or echocardiogram.

• Unless caused by a heart condition, palpitations rarely require treatment — self care focuses on avoiding triggers.

What Are Heart Palpitations?

Heart palpitations are feelings of having a fast-beating, fluttering or pounding heart. The word may sound alarming, but although heart palpitations can be worrisome, they are usually harmless.

Stress, exercise, medication or, rarely, a medical condition can trigger them. Rarely, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

Figure 2: How palpitations feel, their 8 common causes, 6 risk factors, and the symptoms that require emergency medical attention.

How Do Heart Palpitations Feel? The 5 Sensations

Heart palpitations can feel like the heart is:

Sensation	Description
Beating too fast	The heart races noticeably, sometimes at rest.
Flip-flopping	The heart feels like it turns over inside the chest.
Fluttering rapidly	A quick, light, vibrating sensation in the chest.
Pounding	Strong, forceful beats you can feel in your chest.
Skipping beats	A momentary “pause” or missed beat, often followed by a stronger one.

Palpitations may be felt in the throat or neck as well as the chest. They can occur during activity or at rest.

When Are Heart Palpitations an Emergency?

This is the most important distinction to know. Palpitations that are infrequent and last only a few seconds usually don't need to be evaluated. But certain combinations of symptoms require immediate action.

Situation	What to Do
Palpitations with chest discomfort or pain, fainting, severe shortness of breath, or severe dizziness	Seek emergency medical attention immediately.
You have a history of heart disease and palpitations occur frequently or are worsening	Talk to your health care provider — you may need heart-monitoring tests.
Brief, infrequent palpitations with no other worrisome signs	Usually no evaluation needed; make a routine appointment if you're concerned.

If you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your health care provider. You may need heart-monitoring tests to see if the palpitations are caused by a more serious heart problem.

The 8 Common Causes of Heart Palpitations

Often the cause of heart palpitations can't be found. But when a cause is identified, these are the most common ones:

Cause	How It Triggers Palpitations
Strong emotional responses	Stress, anxiety or panic attacks stimulate the body's “fight or flight” response, speeding up the heart.
Depression	A recognized common cause of palpitations.
Strenuous exercise	Intense physical effort temporarily raises heart rate and awareness of the heartbeat.
Stimulants	Caffeine, nicotine, cocaine, amphetamines, and cold and cough medications containing pseudoephedrine.
Fever	Elevated body temperature speeds up the heart.
Hormone changes	Those associated with menstruation, pregnancy or menopause.
Thyroid hormone imbalance	Too much or too little thyroid hormone affects heart rhythm.
Arrhythmia (irregular heartbeat)	Occasionally palpitations are a sign of a more serious problem.

Arrhythmias might cause a very fast heartbeat (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rhythm, or a combination of the three.

The 6 Risk Factors for Heart Palpitations

Risk Factor	Notes
Stress	Ongoing stress raises the likelihood of palpitation episodes.
Anxiety disorder or panic attack	Frequent anxiety responses trigger the fast-beating feeling.
Pregnancy	Hormone and blood-volume changes increase palpitation likelihood.
Certain medicines that contain stimulants	Some cold or asthma medications.
An overactive thyroid gland (hyperthyroidism)	Excess thyroid hormone speeds the heart.
Other heart problems	Irregular heartbeats, structural heart changes, previous heart attack or previous heart surgery.

Possible Complications (When a Heart Condition Is the Cause)

For palpitations caused by a heart condition, possible complications may include:

Complication	How It Happens
Fainting	If the heart beats rapidly, blood pressure can drop, causing the person to faint. This is more likely in those with a heart problem, such as congenital heart disease or certain valve problems.
Cardiac arrest	Rarely, palpitations can be caused by life-threatening heartbeat problems that cause the heart to stop beating effectively.
Stroke	If palpitations are due to atrial fibrillation — a condition in which the upper chambers of the heart quiver instead of beating properly — blood can pool and cause clots to form. If a clot breaks loose, it can block a brain artery, causing a stroke.
Heart failure	Certain arrhythmias can reduce the heart's pumping ability. Sometimes, controlling the rate of an arrhythmia that is causing heart failure can improve the heart's function.

How Are Heart Palpitations Diagnosed?

To diagnose palpitations, a health care provider will do a physical exam and listen to your heart using a stethoscope. The exam may include looking for signs of medical conditions that can cause heart palpitations, such as a swollen thyroid gland. You will likely be asked questions about your medical history.

If your provider thinks that palpitations are caused by an irregular heartbeat or another heart condition, tests might include:

Test	What It Involves	What It Detects
Electrocardiogram (ECG or EKG)	A quick, painless test; sticky patches (electrodes) are placed on the chest and sometimes the arms and legs; wires connect the electrodes to a computer that displays the results.	Whether the heart is beating too slow, too fast or not at all.
Holter monitoring	A portable ECG device worn for a day or more, recording the heart's rate and rhythm during daily activities.	Palpitations that aren't found during a regular ECG exam. Some personal devices, such as smartwatches, offer remote ECG monitoring — ask your provider if this is an option.
Event recording	A device worn for up to 30 days or until you have an arrhythmia or symptoms; you press a button when symptoms occur.	Irregular rhythms that happen less than once weekly or aren't caught by a Holter monitor.
Echocardiogram	A noninvasive exam using sound waves to create moving pictures of the heart in motion.	Blood flow and structural problems with the heart.

How Are Heart Palpitations Treated?

Unless the palpitations are caused by a heart condition, heart palpitations rarely require treatment. Instead, a health care provider might recommend taking steps to avoid the triggers that cause palpitations.

If palpitations are caused by a heart condition, such as an irregular heartbeat (arrhythmia), treatment will focus on correcting the condition.

Figure 3: The four-step pathway from physical exam through heart-monitoring tests and treatment — plus the self-care steps that help avoid palpitation triggers.

Self Care: Avoiding Palpitation Triggers

The most appropriate way to treat palpitations at home is to avoid the triggers that cause the symptoms.

Self-Care Step	What It Means in Practice
Reduce stress	Try relaxation techniques, such as meditation, yoga or deep breathing.
Avoid stimulants	Caffeine, nicotine, some cold medicines and energy drinks can make the heart beat too fast or irregularly.
Avoid illegal drugs	Certain drugs, such as cocaine and amphetamines, can cause heart palpitations.

Getting Ready for Your Appointment

If you have heart palpitations with severe shortness of breath, chest pain or fainting, seek emergency medical attention. If your palpitations are brief and there are no other worrisome signs or symptoms, make an appointment to see your health care provider. A health care provider can help determine if palpitations are harmless or a symptom of a more serious heart condition. You may be referred to a doctor who specializes in heart diseases (cardiologist).

Here's some information to help you get ready for your appointment:

What You Can Do

When you make the appointment, ask if there's anything you need to do in advance, such as restricting your diet.

• Write down your symptoms, including any that seem unrelated to heart palpitations, and when they began.

• Gather key personal information, including family history of heart disease, arrhythmias, stroke, high blood pressure or diabetes, as well as major stresses or recent changes in your life.

• List all medications, vitamins and supplements you take, including doses.

• Prepare your questions to ask your health care provider.

• Take a family member or friend along, if possible, to help you remember the information you're given.

Questions to Ask Your Healthcare Professional

Your Questions	What Your Provider Will Likely Ask You
What is likely causing my symptoms or condition?	Do you always have palpitations or do they come and go?
What are other possible causes?	Do the palpitations start and stop suddenly?
What should I do if my symptoms return?	Do the palpitations seem to occur at the same time every day or during a certain activity?
What tests will I need?	What, if anything, seems to improve symptoms?
Do I need treatment and, if so, what?	What, if anything, appears to worsen symptoms?
I have other health conditions — how can I best manage them together?	Are you having other symptoms such as shortness of breath, chest pain, fainting or dizziness when you have palpitations?
Are there restrictions I need to follow?	Do you have a history of heart rhythm problems, such as atrial fibrillation?
Should I see a specialist?	—
Do you have brochures or other printed material I can have? What websites do you recommend?	—

What You Can Do in the Meantime

Before your appointment, you can try to improve your symptoms by avoiding stress or activities that might cause palpitations. Some common triggers include anxiety or panic attacks, too much caffeine or alcohol, and the use of medications or supplements that contain stimulants, such as energy drinks or some cold medicines.

Conclusion and Next Steps

That sudden fluttering, pounding or skipped-beat feeling is almost always temporary and harmless. Stress, caffeine, nicotine, exercise, fever, hormone changes and thyroid shifts account for most episodes, and many people never learn the exact cause of their palpitations. But the rare occasion matters: when palpitations come from an irregular heartbeat, they can point to an arrhythmia that deserves evaluation — and when they come with chest pain, fainting, severe shortness of breath or severe dizziness, they demand emergency care immediately.

The practical path is simple. If your episodes are brief and infrequent, make lifestyle changes and watch for patterns. If you have a history of heart disease, or your palpitations are frequent or worsening, see your provider — a short physical exam and, when needed, a brief monitoring test can settle the question quickly.

Call to action: If you're experiencing palpitations with chest pain, fainting or severe shortness of breath, seek emergency medical attention right away. Otherwise, track when your palpitations happen, what you were doing, and what you consumed — then bring that log to your appointment so your provider can pinpoint your triggers and decide whether any testing is needed.

Frequently Asked Questions

Are heart palpitations dangerous?

Usually not. Although heart palpitations can be worrisome, they are usually harmless and are often triggered by stress, exercise, medication or, rarely, a medical condition. Rarely, they can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

What causes a fluttering feeling in my chest?

Common causes include strong emotional responses (stress, anxiety, panic attacks), depression, strenuous exercise, stimulants (caffeine, nicotine, cocaine, amphetamines, and cold and cough medications with pseudoephedrine), fever, hormone changes (menstruation, pregnancy, menopause), and too much or too little thyroid hormone. Occasionally the cause can't be found.

What are the 5 sensations of heart palpitations?

Palpitations can feel like the heart is beating too fast, flip-flopping, fluttering rapidly, pounding, or skipping beats. They may be felt in the throat or neck as well as the chest, and can occur during activity or at rest.

When should I go to the ER for heart palpitations?

Seek emergency medical attention if palpitations occur with chest discomfort or pain, fainting, severe shortness of breath, or severe dizziness. These combinations can signal a serious heart problem.

Do palpitations always need testing?

No. Palpitations that are infrequent and last only a few seconds usually don't need to be evaluated. However, if you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your health care provider — you may need heart-monitoring tests.

What is the difference between palpitations and an arrhythmia?

Palpitations are the feeling of a fast-beating, fluttering or pounding heart. An arrhythmia is an actual irregular heartbeat — the heart may beat too fast (tachycardia), too slow (bradycardia), or in a rhythm that varies from the typical pattern. Palpitations are sometimes a symptom of an arrhythmia, but most palpitations have benign causes.

What tests diagnose the cause of heart palpitations?

After a physical exam and medical history, providers may order an electrocardiogram (ECG/EKG), Holter monitoring (a portable ECG worn for a day or more), an event recorder (worn up to 30 days, activated during symptoms), or an echocardiogram (sound waves that show the heart's structure and blood flow).

What can I do at home to stop heart palpitations?

The most appropriate way to treat palpitations at home is to avoid the triggers that cause the symptoms: reduce stress with meditation, yoga or deep breathing; avoid stimulants such as caffeine, nicotine, some cold medicines and energy drinks; and avoid illegal drugs such as cocaine and amphetamines. If palpitations are caused by a heart condition, treatment will focus on correcting the condition — see your provider.

References

1. Heart palpitations: Symptoms & causes. Clinical overview reviewed March 30, 2020. mayoclinic.org

2. Heart palpitations: Diagnosis & treatment. Clinical overview reviewed March 30, 2020. mayoclinic.org

Disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the guidance of your healthcare professional with any questions about a medical condition. In a medical emergency, call 911 or your local emergency number.