Heart palpitations are sensations where you become unusually aware of your heartbeat, which may feel like racing, pounding, fluttering, or skipping beats. While they can be alarming, these episodes are surprisingly common and usually harmless, affecting people of all ages at different times in their lives.

How Common Are Palpitations

Heart palpitations are a widespread experience that affects many people throughout their lives. Research shows that approximately 16% of people visit their primary care provider specifically because they are experiencing palpitations^[1]. In fact, palpitations rank among the most common reasons why people seek care from a heart specialist, known as a cardiologist, who is a doctor specializing in heart conditions^[1].

Almost everyone experiences palpitations at some point in their life^[3]. These sensations can occur at any age and during various life stages. For instance, teenagers may experience them, as can women during pregnancy or menopause^[1]. Women tend to experience palpitations more frequently than men^[1].

With the increasing use of heart rate monitors and wearable technology, doctors have discovered that extra or skipped heartbeats are far more common than previously thought. Most of these irregular beats go completely unnoticed by the person experiencing them^[3].

What Causes Heart Palpitations

The causes of palpitations are numerous and varied. Understanding what triggers these sensations can help distinguish between harmless episodes and those requiring medical attention. In a comprehensive study of 190 patients with palpitations, doctors were able to identify a specific cause in 84% of cases. Among these identified causes, 43% were related to the heart itself, with 40% due to irregular heart rhythms called arrhythmias, which are disturbances in the heart’s electrical system. Another 31% of patients had palpitations caused by anxiety or panic disorders, while 6% experienced them due to street drugs or certain medications^[14].

The heart works harder under certain conditions, and this increased activity can make you more aware of your heartbeat. Physical exertion is a natural trigger—the harder your body works, the more blood your heart needs to pump throughout your system, causing your heart rate to increase^[3]. This is completely normal and expected during activities like running to catch a bus or climbing stairs.

Emotional states play a significant role in triggering palpitations. Strong feelings such as anxiety, stress, fear, and panic can cause your body to release adrenaline, a hormone that prepares your body for action by increasing your heart rate^[1]. Many people notice their heart racing during stressful situations at work, before important events, or during panic attacks^[6].

Medical conditions unrelated to the heart can also cause palpitations. An overactive thyroid, also called hyperthyroidism, occurs when your thyroid gland produces too much hormone, which can speed up your heart rate^[1]. Other conditions include fever, anemia (low red blood cell count), dehydration, low blood sugar levels, and imbalances in important minerals like potassium^[1].

Pregnancy naturally increases the amount of blood circulating in a woman’s body to support the growing baby. This increased blood volume means the heart must work harder, making palpitations a common and usually harmless occurrence during pregnancy^[1].

Sometimes palpitations are related to what you eat. Spicy or rich foods can trigger them, as can meals high in carbohydrates, sugar, or fat. Foods containing large amounts of monosodium glutamate (MSG), nitrates, or sodium may also bring on palpitations in some people^[6].

Risk Factors for Palpitations

Certain groups of people and specific circumstances increase the likelihood of experiencing palpitations. Women are more prone to palpitations than men^[1]. Life stages such as adolescence, pregnancy, and menopause represent times when hormonal changes make palpitations more likely to occur^[5].

People who already have heart disease face a higher risk, as do those with significant risk factors for heart disease or those with abnormal heart valves^[1]. Having a family history of heart problems also increases the likelihood that palpitations might signal a more serious underlying condition^[3].

Lifestyle choices significantly affect the risk of experiencing palpitations. Regular consumption of caffeine from coffee, tea, or energy drinks can make palpitations more frequent^[5]. Smoking and the use of tobacco products, alcohol consumption, and the use of recreational drugs like cocaine and amphetamines all increase the risk^[1].

Physical and emotional stress are major risk factors. People who experience chronic stress, anxiety disorders, or panic attacks are more likely to experience palpitations^[4]. Lack of sleep and fatigue can also trigger episodes^[5].

Certain medical conditions create an environment where palpitations are more likely. These include thyroid disorders, anemia, low blood pressure, and electrolyte imbalances^[5]. People taking medications for asthma, high blood pressure, or thyroid problems may also experience palpitations as a side effect^[1].

Symptoms of Palpitations

The way palpitations feel can vary considerably from person to person, but most people describe an unusual or uncomfortable awareness of their heartbeat. The sensation might feel like your heart is racing, meaning it’s beating much faster than normal. Others describe a pounding sensation, as if the heart is hitting against the chest wall with more force than usual^[1].

Some people experience what they describe as flip-flopping or fluttering, as if the heart is turning over in the chest or moving like the wings of a butterfly. Others feel as though their heart is missing beats or skipping, or conversely, having extra beats^[1]. A fleeting sinking feeling in the chest is also common, particularly in people who have isolated extra heartbeats^[4].

You can feel palpitations not only in your chest but also in your throat or neck^[2]. Some people notice the sensation when sitting or lying still, while others experience it during physical activity or when bending over^[7]. Palpitations can occur during the day or night, though many people notice them more at night when they’re lying in bed because there are fewer distractions^[1].

The duration of palpitations is typically brief. Most episodes last only a few seconds or minutes, although some can persist for longer periods^[1]. The sensations may come on suddenly and then disappear just as quickly, or they may build gradually and fade slowly.

Different patterns of palpitations can suggest different underlying causes. Single skips typically point to isolated premature heartbeats. A rapid, regular pounding that starts and stops abruptly often characterizes a condition called paroxysmal supraventricular tachycardia, which is a specific type of fast heart rhythm. Beats that feel irregular in both rhythm and strength might suggest atrial fibrillation, an irregular heartbeat condition, while a gradually increasing and decreasing heart rate usually indicates normal stress-related increases in heart rate^[4].

Other symptoms that can accompany palpitations include feeling faint or light-headed, breathlessness, and a general feeling of anxiety or unease^[7]. Some people report being able to see their chest moving or fluttering during an episode^[4].

Prevention of Palpitations

While not all palpitations can be prevented, there are many practical steps you can take to reduce their frequency and severity. Identifying and avoiding personal triggers is one of the most effective prevention strategies. If caffeine triggers your palpitations, limiting or eliminating coffee, tea, energy drinks, and caffeinated sodas can help^[5].

Managing stress is crucial for preventing palpitations, as stress and anxiety are major triggers. Techniques like meditation, deep breathing exercises, yoga, and tai chi can help keep stress levels under control^[1]. Taking short breaks from work or school, spending time outdoors, and engaging in hobbies you enjoy can also reduce stress-related palpitations^[12].

Maintaining a healthy lifestyle supports overall heart health and can reduce palpitations. Getting adequate sleep is essential, as fatigue and lack of rest can trigger episodes^[5]. Staying well-hydrated prevents dehydration, which is a known cause of palpitations^[1].

Avoiding or limiting certain substances can significantly reduce palpitation episodes. This includes alcohol, tobacco products, and recreational drugs^[5]. If you smoke, working with your doctor to quit can help, as nicotine is a stimulant that can trigger palpitations^[1].

Before taking any over-the-counter medications, supplements, or herbal products, consult with your doctor. Many cold and cough medicines contain decongestants that can cause palpitations, as can some diet pills and appetite suppressants^[6]. Even seemingly harmless herbal and nutritional supplements can affect your heart rate^[1].

Eating a balanced, heart-healthy diet can help prevent palpitations related to low blood sugar or electrolyte imbalances. Including foods rich in potassium, calcium, and magnesium helps maintain proper electrolyte balance, which is important for regular heart rhythm^[12]. However, people with certain medical conditions like kidney disease should talk to their doctor before increasing potassium intake, as too much can also cause heart rhythm problems^[12].

If you notice that certain foods trigger your palpitations, keeping a food diary can help identify which ones to avoid. Pay attention to meals high in carbohydrates, sugar, fat, MSG, or sodium^[6].

Regular, moderate exercise promotes heart health, but if certain activities trigger palpitations, you should slow down or stop and discuss it with your doctor before continuing that activity^[19]. For people with heart conditions, doctors can provide guidance on which types and intensities of exercise are safe^[20].

How Palpitations Affect the Body

To understand palpitations, it helps to know how the heart normally works. Your heart is responsible for pumping blood throughout your entire body, delivering oxygen and nutrients that keep you alive and healthy. This pumping action is controlled by the heart’s electrical system, which coordinates each heartbeat in a precise rhythm^[3].

With each beat, the heart squeezes in a coordinated fashion, and this steady rhythm keeps blood flowing efficiently through your body. Normally, you don’t notice this process at all—your heart beats approximately 60 to 100 times per minute without you being aware of it^[3].

Palpitations occur when you become unusually aware of this heartbeat, either because the heart is beating faster than normal, with extra or skipped beats, or with a different pattern^[3]. The heart’s electrical system can be affected by many factors, causing temporary changes in rhythm or rate.

When your body needs more oxygen—such as during exercise or stress—your heart naturally beats faster to pump more blood. This increased heart rate is a normal response controlled by your nervous system and hormones like adrenaline. The sensation of palpitations during these times is simply an increased awareness of this normal physiological process^[3].

Sometimes the heart’s electrical system produces extra beats or skips beats. These are called premature contractions and can occur in the heart’s upper chambers (atria) or lower chambers (ventricles). While these extra or skipped beats can be startling, they are usually harmless in people without heart disease^[4].

In some cases, palpitations result from true arrhythmias—abnormal heart rhythms where the heart’s electrical system is not functioning properly. These can range from harmless to potentially serious. Sinus tachycardia is simply a faster than normal heart rate that gradually increases and decreases. Atrial fibrillation is an irregular, often rapid heart rhythm that originates in the upper chambers of the heart. Ventricular tachycardia is a rapid rhythm originating in the lower chambers, which can be more serious^[4].

When the heart beats too fast for prolonged periods, it may not fill completely with blood between beats, potentially reducing the amount of blood pumped to the body. This can explain why some people feel dizzy or short of breath during palpitations^[3].

Certain substances affect the heart’s electrical system and can trigger palpitations. Caffeine, nicotine, and some medications can increase the release of adrenaline or directly affect the heart’s electrical signals. Electrolyte imbalances—particularly of potassium, calcium, and magnesium—can disrupt the heart’s electrical activity because these minerals are essential for the electrical signals that coordinate heartbeats^[12].

The vagus nerve, which connects the brain to the heart, plays a role in controlling heart rate. Certain actions can stimulate this nerve and affect heart rhythm, which is why some people experience palpitations when lying down on their left side or after eating a large meal^[12].

For most people, palpitations don’t cause any lasting changes to the heart or body. The episodes are temporary, and the heart returns to its normal rhythm on its own. However, in people with underlying heart conditions, frequent or prolonged palpitations could potentially lead to complications, which is why proper evaluation by a doctor is important^[3].