Heart Palpitations: Causes, Symptoms, and Treatments

Medically Reviewed by Jabeen Begum, MD on June 03, 2024
Written by Rick Ansorge, Hallie Levine, Kristin Mitchell
8 min read

Palpitations make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

They can be bothersome or frightening, but heart palpitations usually aren't serious or harmful, though, and often go away on their own. Most of the time, they're caused by stress and anxiety, or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant.

If you notice heart palpitations, you should see your doctor. After your doctor takes note of your medical history and do a physical exam (including listening to your lungs and heart), they may order tests to find the cause. If they find one, the right treatment can reduce or get rid of the palpitations.

If there’s no underlying cause, lifestyle changes can help, including stress management.

 

If you have heart palpitations, it may feel like your heart is:

  • Racing
  • Skipping a beat
  • Flip-flopping
  • Pounding in your chest and even your neck

Sometimes, you may feel dizzy or even faint. This may be a sign of a more serious condition.

There can be many. Usually, palpitations are either related to your heart or the cause is unknown. Non-heart-related causes include:

  • Strong emotions like anxiety, fear, or stress. They often happen during panic attacks.
  • Vigorous physical activity
  • Caffeine, nicotine, alcohol, or illegal drugs such as cocaine and amphetamines
  • Medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration
  • Hormonal changes during menstruation, pregnancy, or just before menopause. Sometimes, palpitations during pregnancy are signs of anemia.
  • Medications, including diet pills, decongestants, asthma inhalers, and some drugs used to prevent arrhythmias (a serious heart rhythm problem) or treat an underactive thyroid
  • Some herbal and nutritional supplements
  • Abnormal electrolyte levels

Heart palpitations after eating

Some people have palpitations after heavy meals rich in carbohydrates, sugar, or fat. Sometimes, eating foods with a lot of monosodium glutamate (MSG), nitrates, or sodium can bring them on, too.

If you have heart palpitations after eating certain foods, it could be due to food sensitivity. Keeping a food diary can help you figure out which foods to avoid.

Heart palpitations at night

If you have heart palpitations at night, you may have them during the day, too. You’re just too busy to notice them. If you drink alcohol before bed or eat a big meal, that could contribute to them, too. Take some deep breaths and drink a glass of water -- dehydration can make palpitations worse.

Heart palpitations and anxiety

Anxiety sets off your body’s fight or flight response. This increases your heart rate. They usually go away after a few minutes. If you notice them, you can try some deep breathing. If you get them frequently, talk to your doctor about counseling and possibly anti-anxiety medications.

What causes heart palpitations when lying down?

You may notice heart palpitations when you lie down, especially if you sleep on your side. This position increases pressure on your body, which causes palpitations. Switching to your back may help.

Can low potassium cause heart palpitations?

If your potassium levels become very low, you can develop heart palpitations. Some reasons that might happen include:

  • Laxative use
  • Too much caffeine 
  • A gastrointestinal  bug that causes diarrhea and vomiting
  • Undiagnosed thyroid problems

They can also be related to heart disease. When they are, they’re more likely to represent arrhythmia. Heart conditions tied to palpitations include:

  • Prior heart attack
  • Coronary artery disease
  • Heart failure
  • Heart valve problems
  • Heart muscle problems

When you're pregnant, your heart has to work harder to pump extra blood throughout your entire body. This can lead to heart palpitations. They may feel uncomfortable but they are usually harmless. They go away after you give birth. Some ways to avoid them include:

  • Drink a lot of water. Dehydration makes heart palpitations worse.
  • Limit caffeine, sugar, and fat.
  • Try some deep breathing exercises.

If these don’t help, you can talk to your doctor about taking a type of drug known as a beta-blocker during your pregnancy.

In rare cases, palpitations can be a sign of a more serious heart condition. If you have heart palpitations, see your doctor. Get immediate medical attention if they come with:

  • Shortness of breath
  • Dizziness
  • Chest pain
  • Fainting
  • Back, neck, jaw, or stomach pain
  • Sweating
  • Nausea

All of these could signal a heart attack.

Can heart palpitations cause loss of breath?

They can, but they can also signify a more serious condition such as a heart arrhythmia or even a heart attack. They should be checked right away. 

Your doctor will:

  • Give you a physical exam
  • Take down your medical history
  • Want to know about your current medications, diet, and lifestyle
  • Ask for specifics about when, how often, and under what circumstances your palpitations occur

Sometimes, a blood test can help your doctor find the cause of your palpitations. Other useful tests include:

Electrocardiogram (EKG). This can be done while you’re at rest or exercising. The latter is called a stress EKG. In both cases, the test records your heart's electrical signals and can find unusual heart rhythms.

Holter monitoring. You’ll wear a Holter monitor on your chest. It records your heart's electrical signals for 24 to 48 hours while you're doing normal activities. It can identify rhythm differences that weren't picked up during an EKG.

Event recording. You’ll wear a device on your chest and use a handheld gadget to record your heart's electrical signals when symptoms occur.

Chest X-ray. Your doctor will check for changes in your lungs that could come from heart problems. For example, if they find fluid in your lungs, it may come from heart failure.

Echocardiogram. This is an ultrasound of your heart. It provides detailed information about its structure and function.

If necessary, your doctor may refer you to a cardiologist for more tests or treatment.

Heart palpitations but normal ECG

Sometimes you may have heart palpitations but your ECG is normal. Your doctor may want to run other tests to make sure, like a Holter monitor. But as long as you don’t have other symptoms such as chest pain, your heart is most likely healthy.

This depends on their cause. Often, palpitations are harmless and go away on their own. In that case, no treatment is needed.

If your doctor doesn't find a cause, they may advise you to avoid the things that might trigger the palpitations. Strategies may include:

Ease anxiety and stress. Leave a stressful situation and try to be calm. Anxiety, stress, fear, or panic can cause palpitations. Other common ways to stay calm include:

Cut out certain foods, beverages, and other substances. These may include:

Talk to your doctor about certain medications. You may have to steer clear of:

  • Cough and cold medicines
  • Certain herbal and nutritional supplements

If lifestyle changes don’t help, you may be prescribed medications. In some cases, these will be beta-blockers or calcium-channel blockers.

If your doctor finds a reason for your palpitations, they will focus on treating that reason.

If they’re caused by a medication, your doctor will try to find a different treatment.

If they represent an arrhythmia, you may get medications or procedures. You may also be referred to a heart rhythm specialist known as an electrophysiologist.

How to stop heart palpitations from anxiety

To stop heart palpitations from anxiety, you’ll need to treat the underlying condition. Some ways to do that include:

  • Talk therapy. One popular method is cognitive behavior therapy. It teaches you different ways to think and behave in situations to help your anxiety.
  • Antidepressant and anti-anxiety medications.
  • Beta-blockers. This class of drugs treats high blood pressure, but it can also slow down your heartbeat, too. 
  • Stress management techniques like exercise, yoga, and meditation.

How to stop heart palpitations quickly

It’s important to find the cause of your heart palpitations to help treat them. But there are things you can do at home to help them go away faster:

Take some deep breaths. One good technique is box breathing. Inhale for a count of four, hold your breath for a count of four, then exhale for a count of four. Hold your breath for another count of four. 

Vagal maneuvers. These actions activate your vagus nerve, which helps to control your heart rate. One way to do it is to tense up your muscles, then bear down like you are about to have a bowel movement.

Limit caffeine and alcohol. Both can cause palpitations. They also dehydrate you, which can worsen palpitations.

Make sure to check in with your doctor. Often, palpitations aren’t serious, but they can be related to abnormal heart valves, heart rhythm problems, or panic attacks.

Always call a doctor if palpitations change in nature or increase suddenly.

Call 911 right away if you have these symptoms along with palpitations:

  • Dizziness
  • Confusion
  • Lightheadedness
  • Passing out
  • Shortness of breath
  • Pain, pressure, or tightness in the chest, neck, jaw, arms, or upper back

Heart palpitations are very common, but they’re rarely serious. You may feel like your heart is racing, pounding, or doing flip-flops in your chest. You may notice them after eating, at night, or when you’re stressed. You should always let your doctor know about them to rule out a more serious condition. Most of the time, they can be treated with stress management, dietary changes, and, in certain cases, medication.

How do you stop heart palpitations? 

Treatment depends on the cause. If your heart palpitations are due to heart disease or an arrhythmia (abnormal heart rhythm), you may need medication or surgery. If there’s no cause, you may be able to improve them with lifestyle tweaks, including stress reduction.

How long is too long for heart palpitations? 

They shouldn’t last more than a few minutes. If they do, see your doctor.

What can trigger heart palpitations?

A variety of lifestyle factors can cause them, including:

  • Caffeine
  • Alcohol
  • Exercise
  • Hormonal changes
  • Stress
  • Hormonal changes

Heart palpitations can also be triggered by heart disease, cardiomyopathy (an enlarged heart), or even a heart attack.

What vitamin can stop heart palpitations?

There’s no vitamin that can stop heart palpitations. But if you’re low in vitamin D, calcium, magnesium, potassium, or iron, you’re more at risk for them.

Can you have heart palpitations but normal ECG readings?

Yes. In these cases, your heart palpitations are most likely not serious. Your doctor can let you know.