What Causes Heart Palpitations?

By Temma Ehrenfeld @temmaehrenfeld
May 09, 2019
Why does your heart skip a beat? Learn what causes heart palpitations and you’ll be less frightened. Usually, nothing serious is wrong. Learn more here.

Why does your heart skip a beat? Know what causes heart palpitations and you’ll be less frightened. Usually, nothing serious is wrong. Learn more here.

You may notice at times that your heart is beating too hard or too fast, which you might experience as a sensation in your chest or your throat. Perhaps it skips a beat or flutters. Although feeling something off with your heart can be terrifying, don’t assume you have heart disease.

Most often what causes heart palpitations is temporary: a panic attack or too much alcohol, caffeine, or nicotine. Pregnant women sometimes get them as well, when palpitations may be a sign of anemia.

A normal heart beats 60 to 100 times per minute. If your heart rate is greater than 100 beats per minute, you have tachycardia. If your heart rate is more than 100 beats per minute without exercise, anxiety, or fever, you should see your doctor. Also, you should go to an urgent care facility or emergency room if you have other symptoms — shortness of breath, dizziness, or chest pain, or if you faint.

If your doctor finds you have an abnormal heart rhythm, you may have diagnostic tests, such as an electrocardiogram or an echocardiogram, or you may wear a Holter monitor.

If it turns out you don’t have heart trouble, you may never be sure of your own trigger, but it’s a good idea to talk to your doctors about what causes heart palpitations in general and watch out for another episode. You should rule out possible medication side effects or an underlying medical problem like thyroid disease.


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What causes heart palpitations?

  • Strong emotions like fear can bring on palpitations. They’re common during panic attacks.
  • Vigorous physical activity can trigger palpitations.
  • Caffeine, nicotine, alcohol, cocaine, and amphetamines can trigger palpitations.
  • Thyroid disease, low blood sugar, anemia, low blood pressure, fever, and dehydration can also bring on heart palpitations.
  • Hormonal changes during menstruation, pregnancy, or just before menopause can trigger heart palpitations.
  • Diet pills, decongestants, asthma inhalers, supplements, and drugs used to prevent arrhythmias or an underactive thyroid may be at work.
  • Abnormal electrolyte levels if you are dehydrated can cause palpitations.

A meal heavy in carbohydrates, sugar, or fat — or even too much monosodium glutamate (or MSG), nitrates, or sodium — can bring them on. Keep a food diary to catch any food sensitivities.

If you do have heart disease, it’s most likely an arrhythmia. But you may have a heart valve problem or coronary artery disease.

What you can do

If you are under stress, see what you can do to reduce it. You may need to learn a relaxation technique, like meditation, deep breathing, or guided imagery, and practice it regularly. Spend time outdoors. Be sure you are getting exercise.

Evaluate your diet and drug use. Cut back on stimulants like coffee and caffeinated soda, cigarettes, and some cold medications. Marijuana and high blood pressure medications can cause palpitations.

Stimulate the vagus nerve, which connects your brain to your heart. Sometimes stimulating it can calm projections. Try holding your breath and pushing down as if making a bowel movement. You can also cough, take a cold shower, or splash cold water on your face, or chant “Om.”

Keep your electrolytes balanced, eating foods high in potassium (avocados, bananas, and spinach) and calcium (dairy, dark leafy greens, nuts, and fish).

Keep hydrated. Drink a full glass of water whenever your urine is dark, your mouth feels dry, or you have a headache or feel dizzy.

Avoid too much alcohol.

Get enough aerobic exercise. If exercise triggers palpitations, talk to a coach or doctor.


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February 15, 2023

Reviewed By:  

Janet O’Dell, RN