Heart Palpitations: When to Worry and What to Do

Understand heart palpitations, their causes, symptoms, and when they indicate a serious condition needing medical attention.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 26, 2025

Understand heart palpitations, their causes, symptoms, and when they indicate a serious condition needing medical attention.

Heart palpitations are noticeable changes in your heartbeat that can feel like racing, fluttering, pounding, or skipped beats. While many palpitations are harmless and temporary, some may signal underlying heart problems and warrant medical evaluation. This article explains what heart palpitations are, their common triggers, what they feel like, warning signs, and when you should seek medical attention.

What Are Heart Palpitations?

Heart palpitations refer to you being acutely aware of your heart beating faster, harder, or out of rhythm. These sensations are sometimes completely normal, especially following exertion or emotional stress. However, palpitations can also result from abnormal electrical activity in your heart, known as arrhythmias, which may need prompt medical attention.

You may notice palpitations in your chest, throat, or neck, and they can occur whether you are active, at rest, sitting, or lying down.

Fast-beating or racing heart
Fluttering, pounding, or flip-flopping feeling
Skips in heartbeat
Pounding in the chest, throat, or neck

Common Causes of Heart Palpitations

A variety of factors and medical conditions can trigger heart palpitations. Often, palpitations are benign and related to lifestyle factors, but sometimes they’re tied to health conditions that require evaluation.

Below are the most frequent causes:

Physical Activity (exercise, exertion)
Stress and Anxiety (including panic attacks)
Caffeine (coffee, energy drinks)
Nicotine (smoking, vaping)
Alcohol (especially excessive consumption)
Medications (decongestants, asthma medications, blood pressure drugs)
Hormonal Changes (menstruation, menopause, pregnancy)
Fever or Illness
Stimulant Drugs (cocaine, amphetamines)

Additionally, palpitations can be caused by conditions affecting heart rhythm:

Arrhythmias (abnormally fast, slow, or irregular heartbeats)
Heart disease
Abnormal heart valves
Electrolyte imbalances (especially low potassium)
Thyroid problems (overactive thyroid)

How Heart Palpitations Feel

Sensation	Description
Racing heart	Feels like the heart is beating rapidly, often more than 100 beats per minute (tachycardia).
Fluttering	Feels like quick, light vibration in the chest or throat.
Pounding	Heartbeat that feels forceful or hard in the chest.
Skipped beats	Sensation that the heart missed or paused a beat.
Flip-flopping	Sensation of a sudden change or jump in heartbeat.

These sensations can range from brief and fleeting to persistent and distressing, sometimes accompanied by dizziness, lightheadedness, or a feeling of faintness.

When to Worry About Heart Palpitations

Most heart palpitations are not dangerous and resolve on their own, especially if linked to exercise, stress, or harmless triggers. However, certain patterns and accompanying symptoms could signal a more serious problem requiring prompt medical evaluation.

Situations of Moderate Concern

Frequent or persistent palpitations with no clear cause
Palpitations that interfere with daily life, such as anxiety, sleep disturbance, or difficulty functioning
Palpitations occurring during pregnancy
Palpitations at night or while lying down

If these occur, you should schedule an appointment with your healthcare provider for evaluation—especially if you have risk factors for heart disease, are pregnant, or experience recurring episodes.

Signs of Serious Concern

Call 911 or seek immediate medical attention if palpitations are accompanied by any of the following:

Chest discomfort or pain
Shortness of breath
Severe dizziness or fainting
Nausea or vomiting
Unusual sweating
Overwhelming anxiety or sense of doom

These may be signs of a heart attack, arrhythmia, or other dangerous cardiac events. If you have heart disease, a history of arrhythmia, or major risk factors, take palpitations much more seriously.

Next Steps and Evaluations

For most people, mild palpitations that resolve quickly do not require extensive testing. However, your doctor may recommend evaluation if palpitations are frequent, severe, or accompanied by alarming symptoms. Possible steps include:

Medical history and physical exam
Listening to heart and lungs
Electrocardiogram (ECG or EKG) to check rhythm
Holter monitor (24-hour or longer heart monitoring)
Blood tests for thyroid function, electrolytes, and other checks
Echocardiogram (heart ultrasound)

These tests help detect arrhythmias, heart disease, valve issues, or metabolic causes for palpitations.

Managing and Preventing Heart Palpitations

For palpitations not linked to serious heart conditions, lifestyle modifications can help reduce episodes:

Reduce caffeine, alcohol, and nicotine intake
Manage stress (meditation, breathing exercises, counseling)
Exercise regularly (but consult your doctor if palpitations are frequent)
Avoid stimulant drugs and excessive medications
Get adequate sleep
Monitor and control chronic health conditions (thyroid, blood pressure)

If palpitations are linked to abnormal heart rhythms, heart disease, or other medical issues, you may need medication, procedures, or specialist care. Always follow your healthcare provider’s recommendations.

Heart Palpitations During Pregnancy

Pregnant individuals often experience palpitations because of increased blood volume and hormonal changes. These are usually harmless. However, persistent, severe, or bothersome symptoms should be discussed with a medical professional.

Brief episodes are common; often no intervention is needed.
Prolonged palpitations or those with shortness of breath, chest pain, or dizziness should prompt medical evaluation.
Pregnancy arrhythmias, though rare, require further testing.

Heart Palpitations at Night

Palpitations occurring at night can be due to changes in breathing patterns, anxiety, or underlying arrhythmia.

If episodes are rare and brief, they are usually harmless.
Persistent or disturbing night palpitations may indicate a need for heart monitoring.

Frequently Asked Questions (FAQs)

Are heart palpitations always dangerous?

No, most palpitations are harmless and result from non-cardiac causes like exertion, stress, or stimulants. However, frequent, severe, or symptomatic episodes may signal arrhythmias or heart disease and require medical attention.

Can anxiety cause heart palpitations?

Yes, anxiety activates the fight-or-flight response, which can increase your heart rate and cause palpitations. If anxiety symptoms interfere with your daily life, consult your physician or a mental health professional.

Will lifestyle changes help?

Often, reducing caffeine, alcohol, and nicotine; managing stress; and staying active helps decrease palpitations. Continual episodes despite lifestyle changes should be evaluated medically.

What should I do if I feel palpitations with chest pain?

Seek emergency medical attention immediately, as this could indicate a heart attack or dangerous arrhythmia.

Do I need to see a doctor for every palpitation?

If palpitations are infrequent, brief, and without symptoms like chest pain, fainting, or severe dizziness, medical evaluation may not be necessary. Persistent, recurrent, or symptomatic episodes warrant professional assessment.

Bottom Line

Heart palpitations are common and usually benign, but in some cases, they highlight underlying heart problems. Learning to identify potential warning signs, understanding your individual risk factors, and communicating with your healthcare provider will help you respond appropriately to palpitations and ensure optimal heart health.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete