What are palpitations?

Palpitations are noticeable changes in the way the heart beats. They are not a disease or condition, but a symptom. Most people with palpitations have some type of arrhythmia (irregular heartbeat). While most arrhythmias are not life-threatening, some can indicate serious heart problems.

Heart palpitations can also be a side effect of certain medications and other substances, such as caffeine and nicotine.

This article describes the different ways you may experience heart palpitations, why you may have them, and how your doctor will diagnose and, if necessary, treat the underlying cause.

palpitations symptoms

People experience heart palpitations in different ways. The most common of these are:

  • feeling of heart beating
  • Heartbeat sometimes feels too strong
  • fast and irregular heartbeat
  • arrhythmia

These sensations are felt in the chest. Some people with a specific type of arrhythmia called AV nodal reentrant tachycardia (AVnRT) will notice palpation of their neck.

Heart palpitations are the second most common reason people see a cardiologist (heart specialist).


Arrhythmias are the most common cause of heart palpitations. However, there are many health conditions, medications, and other substances that can cause the heart to beat abnormally.


Most cardiac arrhythmias of any type can cause palpitations. The most common are not dangerous. They include premature atrial contractions (PAC), premature ventricular contractions (PVC), episodes of atrial fibrillation, and episodes of supraventricular tachycardia (SVT).

However, some palpitations are caused by dangerous arrhythmias, such as ventricular tachycardia.

When palpitations have a cardiac cause, they are most likely to occur in people who have heart disease or who experience palpitations at work or while sleeping.

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What causes arrhythmia?

other medical conditions

Other health problems that can cause heart palpitations include:

  • anxiety
  • hyperthyroidism
  • Hypoglycemia
  • low carbon dioxide
  • low potassium
  • anemia
  • dehydration
  • blood loss
  • Shock
  • pregnant

drugs and other substances

Certain over-the-counter (OTC) and prescription drugs are associated with heart palpitations, as are some legal and illegal drugs. Among them:

  • cough and cold medicine
  • Decongestant
  • Weight loss pills
  • beta blockers
  • some herbal supplements
  • asthma inhaler
  • Thyroid medication
  • caffeine
  • nicotine
  • Alcohol
  • Illegal drugs such as cocaine and amphetamines


Palpitations are changes in the way the heart beats. You might see them as beating, excessive, fast, or other irregular heartbeats. They are usually caused by arrhythmias that are not life-threatening, although some can be dangerous and require treatment. Certain other health conditions, medications, and substances can also cause heart palpitations.


If you have heart palpitations, your cardiologist will do an electrocardiogram (ECG), a test that measures the electrical activity of your heart. It produces what’s called a heart rhythm tracker, which looks like a wavy line on a long, special piece of paper.

An EKG can tell your doctor if an arrhythmia is causing your palpitations and help them identify a specific type of arrhythmia.

To properly diagnose arrhythmias, palpitations must be captured in real-time during the test. This can be tricky if your heart palpitations happen occasionally.

In this case, your cardiologist may perform what’s called Holter monitoring (AECG).Ambulatory monitoring systems involve attaching monitors to your body throughout your day.

There are several types of dynamic monitoring. They include:

  • Holter monitoring, which records heart rhythm for 24 to 48 hours or up to several weeks
  • An event monitor, which is a portable ECG device used only when symptoms are present
  • An implantable loop recorder that requires minor surgery to place a device in the chest to monitor heart rhythm for up to three years


Arrhythmias that cause palpitations usually do not require treatment. An important exception is ventricular tachycardia, which, if left unaddressed, can lead to cardiac arrest and even death.

When arrhythmias do require treatment, options include:

  • Antiarrhythmic drugs that directly affect the heart to help it beat normally, including Betapace (sottorol), Tambocor (flecainide), Rhythmol (propafenone), and Cordarone, Pacerone (amiodarone)
  • Calcium channel blockers: blood pressure drugs that prevent calcium from entering the heart, blood vessels, and pancreas
  • beta-blockers: drugs that block certain hormones, such as epinephrine, that cause your heart rate to increase and your blood vessels to narrow
  • Anticoagulants: drugs that thin the blood and prevent it from clotting
  • radiofrequency ablation: a method that uses energy similar to microwaves to destroy areas of the heart that cause irregular heartbeats
  • Implantable Cardioverter-Defibrillator (ICD): A device implanted under the skin that is connected to the heart with wires. ICD tracks heart rate. If it becomes irregular, it will use electric shocks to make the heart beat normally.

If the palpitations are not caused by the arrhythmia, treatment will depend on what it is. This could mean, for example, anti-anxiety medication and treatment for people with heart palpitations from extreme anxiety, or treating conditions such as hyperthyroidism or hypoglycemia.

When a prescription drug causes heart palpitations, changing the dose or switching to another drug may prevent them from happening. Never do this without first consulting your doctor.

Reducing your caffeine or alcohol intake, quitting smoking, and staying away from over-the-counter or illegal drugs, when any of these cause heart palpitations, should also prevent them.

how to treat arrhythmia


Palpitations are noticeable changes in the way the heart beats. They can be caused by irregular heartbeats (arrhythmias), other health conditions, certain drugs, and caffeine, nicotine, and illegal drugs.

To diagnose palpitations associated with heart problems, a cardiologist will perform an electrocardiogram or other form of heart rhythm monitoring.

Treatment for palpitations depends on the cause. You may just need to make lifestyle changes, such as reducing your coffee intake or quitting smoking. Or, you may need to take medication, adjust your current medication, or have surgery to help your heart keep a normal rhythm.

VigorTip words

Feeling like your heart seems to be beating faster or slower than usual can be disconcerting, to say the least.

If this happens to you, unless you’ve already been diagnosed with heart disease, your chances of having a serious heart attack are relatively low. It could be that you’re drinking too much coffee, or the decongestant you’re taking for a stuffy nose is affecting your heart rate.

To be sure, call your healthcare provider. They will be able to figure out what’s going on and give you the treatment you need if you do have a medical problem.