Palpitations Causes: Medical Information & Health Facts

What Are Palpitations?

Heart palpitations are common sensations in which your heartbeat feels irregular, fast, fluttering, or pounding — often described as skipping or racing beats.

To define palpitations simply, they are the uncomfortable awareness of your heartbeat when it feels irregular, fast, or unusually strong. The heart palpitations meaning encompasses sensations of pounding, racing, fluttering, or beating irregularly that you can feel in your chest, throat, or neck. These episodes typically last seconds to minutes and can occur during rest, activity, or emotional stress.

What are palpitations from a medical perspective? They reflect increased awareness of your heartbeat, which may result from normal rhythm variations or true arrhythmias (abnormal heart rhythms). While often alarming, most palpitations are benign and transient, particularly when not associated with structural heart disease or major arrhythmias. However, understanding when palpitations require medical attention remains crucial for your health and peace of mind.

What Causes Heart Palpitations?

Palpitations causes vary widely, ranging from lifestyle factors to underlying medical conditions.

Here are the most frequent triggers:

• Emotional and Physical Triggers:
  • Stress, anxiety, and panic attacks
  • Strenuous exercise or sudden physical activity
  • Strong emotional responses like fear or excitement
  • Lack of sleep or sudden awakening
• Substances and Medications:
  • Caffeine from coffee, tea, or energy drinks
  • Nicotine from cigarettes or tobacco products
  • Alcohol consumption, especially in excess
  • Decongestant medications containing pseudoephedrine or phenylephrine
  • Cold and cough medications
• Hormonal and Physiological Changes:
  • Hormonal fluctuations during menstruation, pregnancy, perimenopause, or menopause
  • Fever from illness or infection
  • Low blood sugar levels
  • Dehydration or electrolyte imbalances

Medical Conditions That Trigger Palpitations

Several underlying health conditions can cause heart palpitations as a primary symptom. Arrhythmias—abnormalities in the heart’s electrical conduction—are the most important cardiac causes of palpitations. These include atrial fibrillation, where the heart's upper chambers beat irregularly, and other rhythm disorders that disrupt normal electrical conduction.

Heart valve disorders, particularly mitral valve prolapse, frequently trigger heart palpitation episodes. When heart valves don't function properly, they can create turbulent blood flow that manifests as noticeable heartbeats. Heart failure may cause palpitations due to compensatory increases in heart rate or coexisting rhythm disturbances as the heart struggles to pump blood effectively.

Thyroid disorders significantly impact heart rhythm. An overactive thyroid (hyperthyroidism) can cause rapid heartbeat and atrial fibrillation, while an underactive thyroid (hypothyroidism) may lead to bradycardia or premature beats. Anaemia, characterised by insufficient red blood cells, forces the heart to work harder to deliver oxygen, often resulting in heart palpitations and fatigue.

How Do Stress and Anxiety Contribute to Palpitations?

Emotional stress and anxiety are among the most frequent non-cardiac triggers of palpitations. When you experience anxiety or stress, your body releases adrenaline, triggering the "fight or flight" response. This hormonal surge increases heart rate and blood pressure, making you acutely aware of your heartbeat.

Are you wondering why anxiety seems to make palpitations worse? The relationship is bidirectional – stress causes palpitations, but feeling your heart race can increase anxiety, creating a cycle that perpetuates both symptoms. Panic attacks particularly intensify this connection, often causing rapid heart palpitations alongside breathlessness and chest discomfort.

Understanding this stress-palpitation connection helps explain why many episodes occur during challenging life periods or high-pressure situations. Recognising these patterns can guide you towards effective stress management strategies.

Palpitations During Pregnancy

Pregnancy naturally increases the likelihood of experiencing heart palpitations due to major physiological changes. Hormonal shifts—especially rising oestrogen levels—alter blood flow and heart rate regulation, while a 30–50% increase in blood volume makes the heart work harder to support both mother and baby. These normal adaptations can make you more aware of your heartbeat, leading to palpitations that are usually harmless.

However, the ICMR guidelines on ante-natal management of normal pregnancy advise that anyone experiencing palpitations along with easy tiredness or breathlessness at rest or mild exertion should seek immediate medical attention. Always discuss new or worsening symptoms with your healthcare provider to ensure maternal and foetal wellbeing.

How Do Lifestyle Factors Affect Palpitations?

• Dietary Influences:
  • Excessive caffeine intake stimulates heart rate
  • Large meals can trigger palpitations through increased blood flow to digestion
  • Alcohol disrupts normal heart rhythm patterns
  • Maintain 7–8 hours of sleep per night and stay well-hydrated, as dehydration and fatigue can both trigger palpitations
• Physical and Environmental Factors:
  • Intense exercise naturally elevates heart rate
  • Poor sleep quality affects heart rhythm regulation
  • Sudden temperature changes can trigger palpitations
  • Certain medications increase heart rate as side effects

When to See a Doctor for Palpitations?

While most palpitations are harmless, certain symptoms warrant immediate medical attention:

• Seek Emergency Care If You Experience:
  • Chest pain or pressure accompanying palpitations
  • Severe shortness of breath or difficulty breathing
  • Fainting, dizziness, or feeling lightheaded
  • Palpitations lasting more than 10–15 minutes, especially with dizziness or chest pain
• Schedule a Medical Appointment For:
  • Frequent or worsening palpitation episodes
  • Palpitations with existing heart conditions
  • Episodes affecting daily activities or sleep
  • Concerns about underlying heart problems

Can palpitations indicate serious heart conditions? While most are benign, persistent or severe episodes may signal arrhythmias, heart valve disorders, or other cardiac issues requiring evaluation.

Diagnostic and Imaging Methods for Detecting Heart Palpitations

Healthcare providers use several approaches to evaluate palpitations:

1. Detailed Medical History: Your doctor will ask about symptom patterns, triggers, duration, and associated symptoms
2. Physical Examination: Includes listening to your heart, checking pulse, and measuring blood pressure
3. Electrocardiogram (ECG): Records heart's electrical activity to detect rhythm abnormalities
4. Holter monitor: Records continuous ECG activity over 24–48 hours to detect rhythm abnormalities that occur intermittently
5. Blood tests: Evaluate thyroid function, haemoglobin levels, blood glucose, and electrolytes (potassium, magnesium, calcium)
6. Echocardiogram: Ultrasound imaging to evaluate heart structure and valve function

Treatment Options for Palpitations

Treatment depends on the underlying rhythm disturbance or physiological trigger, with most benign palpitations improving through trigger management. For stress-related episodes, relaxation techniques, counselling, and stress management prove effective. When thyroid disorders trigger palpitations, treating the underlying condition typically resolves symptoms. Heart valve disorders may require medication or surgical intervention, while anaemia treatment involves addressing iron deficiency or other underlying causes.

Understanding how to stop heart palpitations often involves lifestyle modifications combined with medical treatment when necessary. Your healthcare provider may recommend avoiding triggers, managing stress, and treating underlying conditions. In certain cases, beta-blockers or calcium channel blockers may be prescribed to control heart rate or rhythm, while anxiety-related palpitations benefit from relaxation therapy or short-term anxiolytics.

Palpitations: Risk Factors and Prevention

• Common Risk Factors Include:
  • Family history of heart disease or arrhythmias
  • Existing heart conditions or previous heart surgery
  • Thyroid disorders or hormonal imbalances
  • High blood pressure or diabetes
  • Excessive stress or anxiety disorders
• Prevention Strategies:
  • Limit caffeine and alcohol consumption
  • Practice regular stress management techniques
  • Maintain 7–8 hours of sleep per night and stay well-hydrated, as dehydration and fatigue can both trigger palpitations
  • Exercise regularly but avoid overexertion
  • Manage underlying health conditions effectively

How to Manage Palpitations at Home?

• Immediate Techniques:
  • Practice slow, deep diaphragmatic breathing to stimulate the vagus nerve, which helps slow heart rate and ease palpitations
  • You may try the Valsalva manoeuvre—a brief, gentle attempt to exhale against a closed airway (as if straining during a bowel movement)—only if advised by a doctor and if you have no heart disease.
  • Splashing cold water on your face may help slow your heart rate through vagal stimulation; however, avoid prolonged or extreme exposure
  • Change positions slowly to avoid sudden heart rate changes
• Long-term Management:
  • Maintain regular sleep schedules
  • Stay adequately hydrated throughout the day
  • Practice meditation or yoga for stress reduction
  • Keep a symptom diary to identify triggers

Conclusion

Understanding heart palpitations empowers you to respond appropriately when they occur. While most episodes result from benign causes like stress, caffeine, or hormonal changes, recognising when to seek medical care ensures your safety and peace of mind. The meaning of palpitations extends beyond simple heart awareness – they often reflect your body's response to various internal and external factors.

At Metropolis Healthcare, we support your journey towards better heart health through comprehensive testing and reliable diagnostics. With over 4,000 advanced tests including ECG monitoring, thyroid function panels, and anaemia screening, our services help identify underlying causes of palpitations. Our network of 10,000+ touchpoints across India ensures convenient access to accurate testing, while our home sample collection service brings healthcare directly to you.

FAQs

What causes heart palpitations?

Palpitations can be triggered by stress, anxiety, caffeine, dehydration, hormonal changes, or lack of sleep. They may also occur during pregnancy or with certain medications.

Are palpitations a sign of a heart problem?

Not always. Most palpitations are harmless, but if they occur with chest pain, dizziness, breathlessness, or fainting, they may indicate a heart issue and require medical evaluation.

Can palpitations go away on their own?

Yes. Many palpitations are short-lived and resolve without treatment, especially if caused by lifestyle factors like stress or stimulants.

How do I stop palpitations naturally?

Try deep breathing, staying hydrated, reducing caffeine, and managing stress. Resting and avoiding triggers often helps symptoms settle quickly.

References
•    https://www.hopkinsmedicine.org/health/conditions-and-diseases/palpitations
•    https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952342_obg_antenatal_management.pdf
•    https://medlineplus.gov/ency/article/003081.htm
•    https://www.mountsinai.org/health-library/symptoms/heart-palpitations
•    https://www.nhs.uk/symptoms/heart-palpitations/