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What causes palpitations? 46 possible conditions

Heart Palpitations

A heart palpitation is the sensation that your heart has skipped a beat or added an extra beat. It may feel like your heart is racing, pounding, or fluttering. You may become overly aware of your heartbeat. This sensation is sometimes also felt in the neck, throat, or chest. While you are having palpitations, your heart rhythm may or may not be abnormal.

Heart palpitations can be caused by a variety of factors, including caffeine, exercise, smoking, or stress.

Although they can be quite unsettling, most heart palpitations are harmless and resolve on their own without treatment.

Rarely, heart palpitations are a sign of a serious condition. Seek medical attention immediately if your heart palpitations are accompanied by other symptoms such as chest pain, fainting, difficulty breathing, or if you have previously diagnosed heart problems.

Causes of Heart Palpitations

Heart palpitations can be caused by a wide variety of things, including:

  • strenuous exercise
  • caffeine (coffee, tea, chocolate, and cola drinks)
  • nicotine from tobacco products such as cigarettes and cigars
  • stress, anxiety, fear, or panic
  • dehydration
  • hormonal changes, including pregnancy
  • electrolyte abnormalities
  • low blood sugar
  • anemia
  • overactive thyroid (hyperthyroidism)
  • low levels of oxygen or carbon dioxide in the blood
  • blood loss
  • shock
  • fever
  • over-the-counter medications, including cold and cough medications, herbal supplements, and nutritional supplements
  • prescription medications, including beta blockers, asthma inhalers, and decongestants
  • illegal drugs such as amphetamines and cocaine

Most heart palpitations are benign (harmless), but they can be a sign of illness when you also have:

  • irregular heartbeat or rhythm changes (arrhythmia)
  • previously diagnosed heart disease
  • heart disease risk factors
  • a defective heart valve

Seek medical attention right away if your palpitations are accompanied by:

  • dizziness or lightheadedness
  • fainting
  • loss of consciousness
  • confusion
  • breathing difficulty
  • profuse perspiration
  • pain, pressure, or tightening in your chest
  • pain in your arms, neck, chest, jaw, or upper back
  • a resting pulse rate of more than 100 beats per minute

These could be signs of a more serious condition.

Diagnosing the Cause of Heart Palpitations

The cause of heart palpitations can be very difficult to diagnose, especially if the palpitations don’t occur while you are in the doctor’s office.

Your physician will probably conduct a thorough physical examination to identify a cause. Be prepared to answer questions about your physical activities, stress levels, prescription and over-the-counter medication and supplement use, and previously diagnosed health conditions.

If necessary, your doctor may refer you to a heart specialist (cardiologist). Tests to help rule out certain diseases or heart problems include:

  • blood tests
  • urine tests
  • a stress test
  • Holter monitor (a portable machine that records the heart’s rhythm for 24 hours)
  • echocardiogram (ultrasound of the heart)
  • electrocardiogram (EKG)
  • X-ray of the chest
  • electrophysiology study (EPS, to check the heart’s electrical function)
  • coronary angiography (to check how blood flows through your heart)

Treatment for Heart Palpitations

Treatment depends on the cause of your palpitations. Any underlying medical conditions will have to be addressed.

Most of the time, no cause for palpitations is found, and no treatment is advised.

If your palpitations are due to controllable lifestyle choices such as smoking or too much caffeine, simply cutting down or eliminating those substances may be all that is needed. If you think medication may be the problem, ask your doctor about alternative medications or treatments.

Preventing Heart Palpitations

If your doctor tells you that treatment is not necessary, there are steps you can take to decrease your chance of palpitations:

  • Keep a log of your activities, as well as the foods and beverages you eat. Note incidents of heart palpitations. Try to identify your triggers and avoid them.
  • If you are anxious or stressed, try relaxation exercises, deep breathing, yoga, tai chi, etc.
  • Limit or stop your intake of alcohol and caffeine.
  • Don’t smoke or use tobacco products.
  • If medication is causing palpitations, ask your doctor if there are any alternatives.
  • Exercise regularly.
  • Stick to a healthy diet and try to keep blood pressure and cholesterol levels under control.

Article Sources:

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See a list of possible causes in order from the most common to the least.



Hyperventilation happens when you suddenly start breathing very quickly. Exhaling more than you inhale causes low carbon dioxide levels.

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Abnormal Heart Rhythms

This condition is considered a medical emergency. Urgent care may be required.

An abnormal heart rhythm (arrhythmia) is a change in the heart's beating pattern. There are many different types with different causes and effects. Possible symptoms are feeling faint, chest pain, and sweating.

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The thyroid gland produces a hormone that controls how your cells use energy. Hyperthyroidism occurs when the body produces excessive amounts.

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Heart Murmurs and Other Sounds

A murmur is a blowing, whooshing, or rasping sound that occurs during a heartbeat. It may be an early indicator of a serious heart condition.

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Paroxysmal Supraventricular Tachycardia (PSVT)

This condition is considered a medical emergency. Urgent care may be required.

Paroxysmal supraventricular tachycardia (PSVT) is a faster-than-normal heart rate. It can last from a few minutes to several hours. PSVT is a fairly common type of (arrhythmia) that can occur in a person of any age.

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Atrial Fibrillation and Flutter

Atrial fibrillation and atrial flutter are irregular heart rhythms that occur when the upper chambers of your heart (the atria) beat too fast.Atrial fibrillation can be sustained or can occur in bursts. It creates a...

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Ventricular Tachycardia

This condition is considered a medical emergency. Urgent care may be required.

Ventricular tachycardia (VT) is a very fast heartbeat caused by a malfunction of the heart's pacing mechanism. VT can occur with or without heart disease. Symptoms include fainting, dizziness, and more.

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Atrial Flutter

Atrial flutter (AFL) is a type of abnormal heart rate, or arrhythmia. It occurs when the upper chambers of your heart (the atria) beat too fast. When the top of your heart (atria) beats faster than the botto...

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Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) occurs when the heart muscle (myocardium) becomes thicker than normal. This interferes with your heart's ability to pump blood. Possible symptoms are dizziness, chest pain, and more.

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Sick Sinus Syndrome

Sick sinus syndrome (SSS) is a general name for a group of disorders caused by a malfunctioning sinus node. The sinus node acts as a pacemaker inside the heart. Sinus rhythm (the normal beating of the heart) i...

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High Blood Pressure Overview

High blood pressure (hypertension) increases your risk for heart attack, stroke, coronary heart disease, and other serious health problems. Left untreated, high blood pressure can damage blood vessels and vital organs.

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Cardiomyopathy is a progressive disease of the heart muscle. Learn about the types, symptoms, treatment, and prognosis of this disease.

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Aortic Valve Disease

Aortic valve disease is a condition that occurs when the main artery of your body, the aorta, and the left ventricle of the heart malfunction. The aortic valve determines how blood flows from the left ventricle (th...

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Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs after experiencing or witnessing a traumatic event. PTSD can cause disruptive symptoms of panic, increased arousal, and mental/emotional problems.

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Mitral Valve Prolapse

Your mitral valve is located on the left side of your heart, between two chambers, the atrium and the ventricle. Blood is pumped from the left atrium through the mitral valve and into the left ventricle on its way t...

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What is anxiety? Anxiety often manifests itself as an apprehension about daily life. Learn the basics with this overview of the types of anxiety disorders.

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Panic Disorder

Panic disorder is a condition chararcterized by persistent anxiety and recurrent panic attacks. Sweating or chills are possible signs of a panic attack.

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Generalized Anxiety Disorder

People who suffer from generalized anxiety disorder, or GAD, worry uncontrollably about common occurrences and situations. The condition may also be called chronic anxiety neurosis.GAD is different than normal feeling...

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Drug Allergy Overview

This condition is considered a medical emergency. Urgent care may be required.

A drug allergy is an allergic reaction to a medication. Your immune system identifies the drug as foreign and acts to eliminate it from your body.

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Hypertensive Heart Disease

Hypertensive heart disease refers to heart conditions caused by high blood pressure. Possible signs of acute hypertension include sweating and chills.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.