Heart palpitations: causes, symptoms, warning signs and what to do

Heart palpitations can be surprisingly unsettling. One moment you feel perfectly normal, and the next you become very aware of your heartbeat. It may seem as though your heart is racing, pounding against your chest, fluttering, skipping a beat or beating unusually hard.

The good news is that most heart palpitations are not dangerous. Stress, anxiety, caffeine, dehydration, exercise, lack of sleep and certain medicines can all make you more aware of your heartbeat. However, palpitations can sometimes occur because of an abnormal heart rhythm, thyroid disorder, anaemia, electrolyte imbalance or another heart condition.

The important question, therefore, isn’t simply “Are heart palpitations dangerous?” It is why are they happening, how often do they occur, how long do they last, and are there any other symptoms?

This guide explains what heart palpitations feel like, their common causes, what you can do when they happen, which foods and drinks may trigger them, and when it is important to have your heart checked.

What are heart palpitations?

Heart palpitations are an awareness of your heartbeat. They are a symptom rather than a diagnosis.

You may feel your heart:

• Racing or beating unusually fast
• Pounding strongly in your chest
• Fluttering or trembling
• Skipping a beat
• Adding an extra beat
• Beating irregularly
• Thumping in your chest, throat or neck

Some people notice palpitations while exercising, while others experience them while sitting quietly or lying in bed. They can last seconds or minutes, although occasionally they continue for longer.

Importantly, feeling a palpitation does not necessarily mean that your heart is beating abnormally. Sometimes the heart rhythm is completely normal, but you become more aware of it.

What does heart palpitation feel like?

Heart palpitations can feel different from person to person.

Someone may describe the sensation as:

“My heart suddenly started racing.”

Another person may say:

“It felt like my heart stopped for a second and then gave a big thump.”

Others describe a fluttering sensation in the chest or a heartbeat that seems to pound in the throat.

An occasional skipped or extra beat can be caused by a premature heartbeat. These can occur even in people without heart disease. Stress, insufficient sleep, caffeine, alcohol, nicotine and electrolyte disturbances can contribute to premature beats.

What causes palpitations in the heart?

There isn’t one single cause of heart palpitations. Common triggers and medical causes include:

Stress and anxiety

Stress activates the body’s “fight or flight” response. Hormones such as adrenaline can increase heart rate and make each heartbeat feel stronger.

Anxiety and panic can therefore cause very noticeable palpitations, even when the heart itself is structurally healthy.

Caffeine

Coffee, tea, energy drinks, cola and caffeine-containing supplements can trigger palpitations in some people. Sensitivity varies considerably. A quantity that causes no problem for one person may cause racing or pounding heartbeats in another.

Dehydration

When you don’t drink enough fluids, your body’s fluid and electrolyte balance can change. Dehydration may contribute to a faster heartbeat and palpitations.

Exercise

A faster heartbeat during or shortly after exercise is normally expected. However, palpitations that are unusually intense, prolonged or accompanied by chest pain, dizziness or fainting should be evaluated.

Lack of sleep

Poor sleep can make the nervous system more reactive and may contribute to palpitations, particularly when combined with stress or caffeine.

Alcohol and nicotine

Alcohol and nicotine can trigger palpitations in some people. Smoking and other nicotine products can stimulate the cardiovascular system.

Thyroid problems

An overactive thyroid can increase heart rate and cause palpitations.

Anaemia

Iron-deficiency anaemia and other forms of anaemia can cause the heart to work harder to deliver oxygen around the body, potentially resulting in a faster or more noticeable heartbeat.

Electrolyte imbalance

Potassium, magnesium and calcium play important roles in normal muscle and electrical function. Significant abnormalities can contribute to abnormal heartbeats or palpitations.

Medicines and supplements

Some medicines, including certain decongestants and other stimulatory medications, can cause palpitations. Some herbal or nutritional supplements may also have an effect.

Heart rhythm problems

Palpitations can sometimes be caused by an arrhythmia, such as atrial fibrillation or another abnormal rhythm. This is one reason recurring or unexplained palpitations should not simply be dismissed.

Why am I suddenly getting palpitations?

Sudden palpitations do not automatically mean that something serious has happened to your heart.

A new episode can follow a stressful event, poor sleep, dehydration, increased caffeine intake, alcohol, intense exercise, illness or certain medicines.

However, new, recurrent or increasingly frequent palpitations deserve medical evaluation, particularly if there is a known heart condition or a family history of heart problems. NHS guidance recommends medical assessment when palpitations keep returning, become more frequent or last longer than a few minutes.

Should I worry about heart palpitations?

Usually, occasional palpitations without other symptoms are not an emergency. But that doesn’t mean every episode should be ignored.

Seek urgent medical attention if palpitations occur with:

• Chest pain or pressure
• Shortness of breath
• Fainting or near-fainting
• Significant dizziness or lightheadedness
• Unusual sweating
• Severe weakness
• A heartbeat that remains very fast or does not settle

These symptoms can occur with serious rhythm problems or other cardiovascular emergencies.

If you are currently experiencing palpitations accompanied by chest pain, severe breathlessness, fainting or significant weakness, seek emergency medical care rather than trying to manage the episode at home.

What are 5 signs your heart is in danger?

There isn’t a single list that can determine whether your heart is “in danger,” but five important warning symptoms that should not be ignored are:

1. Chest pain, pressure or squeezing
2. Shortness of breath
3. Fainting or feeling that you may faint
4. Pain or discomfort spreading to the arm, back, neck or jaw
5. Cold sweating, nausea or marked lightheadedness

These can be warning signs of a heart attack or another cardiovascular emergency, especially when they occur suddenly or together.

Women can sometimes experience less typical heart attack symptoms, including unusual tiredness, nausea, shortness of breath, back or jaw discomfort and weakness.

How to relieve heart palpitations?

If you are otherwise well and your palpitations are mild, several simple measures may help:

• Stop strenuous activity and sit somewhere comfortable.
• Take slow, controlled breaths.
• Drink water if you may be dehydrated.
• Avoid additional caffeine, nicotine and alcohol.
• Try to reduce anxiety rather than repeatedly checking your heartbeat.
• Note what you were doing, eating or drinking before the episode began.

If stress is a trigger, breathing exercises, meditation and other relaxation techniques may help reduce episodes.

However, these measures do not treat an underlying arrhythmia. Recurrent palpitations need to be assessed according to their cause.

Can drinking water stop heart palpitations?

Sometimes, but not always.

If dehydration is contributing to your palpitations, drinking water and correcting fluid loss may help. But water will not necessarily stop palpitations caused by an arrhythmia, thyroid disorder, anaemia or another medical condition.

There is no special drink that universally “removes” palpitations.

If you’re dehydrated, plain water is generally a sensible choice. If substantial fluid or electrolyte loss has occurred through vomiting, diarrhoea, heavy sweating or illness, a healthcare professional may recommend an appropriate oral rehydration solution.

What to drink to remove palpitations?

There is no specific drink that cures heart palpitations.

If dehydration is a likely trigger, water may help. The more important step is identifying and avoiding your individual triggers.

If caffeine triggers your palpitations, switching from coffee or energy drinks to a non-caffeinated beverage may be useful. Avoid using alcohol as a way to relax during palpitations, since alcohol itself can trigger episodes in some people.

What foods should I avoid if I have heart palpitations?

There is no universal “palpitations diet.” However, some people notice symptoms after consuming:

• Large amounts of caffeine
• Energy drinks
• Alcohol
• Very large or rich meals
• Very spicy foods
• High-sugar stimulant products
• Certain supplements

Cleveland Clinic notes that spicy or rich foods, caffeinated drinks and alcohol can trigger palpitations in some people.

Rather than unnecessarily eliminating many foods, keep a palpitation diary. Record what you ate or drank, your sleep, stress level, exercise and when the palpitations occurred. Patterns can make individual triggers easier to identify.

What vitamin deficiency causes palpitations?

There is no single vitamin deficiency that explains most palpitations.

Nutritional and electrolyte abnormalities can sometimes contribute. In particular, low magnesium, potassium or calcium can affect normal electrical activity and may contribute to palpitations.

Iron deficiency can cause anaemia, which may also be associated with a faster or more noticeable heartbeat.

Vitamin D is sometimes discussed in relation to palpitations, but it is important not to assume that vitamin D deficiency is the cause of unexplained palpitations. A doctor may recommend blood tests based on your symptoms and medical history.

Do not start high-dose vitamin or mineral supplements simply because you are experiencing palpitations.

Can too much vitamin D cause heart palpitations?

Yes, excessive vitamin D intake can indirectly cause heart rhythm problems.

Very high vitamin D levels can lead to excessive calcium levels in the blood, or hypercalcaemia. Severe vitamin D toxicity can cause symptoms including dehydration and, in extreme cases, an irregular heartbeat. Excessive vitamin D is generally associated with overuse of supplements rather than sunlight exposure.

This is another reason to avoid taking large doses of supplements without medical advice.

How long should heart palpitations last?

There is no single duration that is considered “normal.”

Many palpitations last only a few seconds or minutes. Some can last longer.

What matters is the pattern. A brief, occasional palpitation in an otherwise healthy person is different from episodes that:

• Last for many minutes or hours
• Keep returning
• Are becoming more frequent
• Start suddenly and remain very fast
• Occur with chest pain, breathlessness, dizziness or fainting

Persistent or recurrent episodes should be evaluated rather than repeatedly self-treated.

Is it okay to sleep while palpitating?

If you have an occasional mild palpitation, feel otherwise well and have no warning symptoms, there may not be a reason to panic simply because it happens at bedtime.

In fact, palpitations can seem more noticeable at night because there are fewer distractions.

However, do not simply go to sleep to “wait out” concerning symptoms. If palpitations are persistent or accompanied by chest pain, significant breathlessness, fainting, severe dizziness or other alarming symptoms, seek urgent medical attention.

What’s the best position to stop palpitations?

There is no medically proven body position that stops every type of palpitation.

If you’re having mild palpitations, sitting upright in a comfortable position and resting may make you feel more comfortable. Slow breathing can also help when stress or anxiety is contributing.

If lying down makes you more aware of your heartbeat, changing position may make the sensation less noticeable. But changing position does not correct an underlying abnormal heart rhythm.

How do I check my heart palpitations?

The first step is to observe and record the episode.

Write down:

• When it started
• How long it lasted
• Whether the heartbeat felt fast, slow, regular or irregular
• What you were doing
• Whether you had coffee, tea, alcohol or an energy drink
• Whether you were stressed or anxious
• Whether you had exercised
• Any accompanying symptoms

A doctor may then perform an ECG (electrocardiogram) to assess the heart’s electrical activity.

If the palpitations come and go, a normal ECG taken between episodes may not capture the abnormal rhythm. Your doctor may therefore recommend a Holter monitor or another ambulatory heart monitor that records your heartbeat over a longer period. Other tests may include blood tests, an echocardiogram or an exercise stress test, depending on the clinical situation.

How do I check if my heart is okay?

There isn’t one test that can prove that every aspect of your heart is completely normal.

A medical evaluation may include:

Blood pressure and pulse: These provide basic information about cardiovascular function.

ECG: An ECG records the electrical activity and rhythm of your heart.

Echocardiogram: An echocardiogram uses ultrasound to assess heart structure and function.

Holter or rhythm monitoring: This can identify intermittent abnormal rhythms that may not appear during a short ECG.

Blood tests: Depending on the symptoms, these may look for anaemia, thyroid problems or electrolyte abnormalities.

The appropriate combination depends on your symptoms, age, medical history and cardiovascular risk factors.

What are mini heart attacks?

“Mini heart attack” is not a precise medical diagnosis.

People sometimes use the phrase to describe a smaller or less dramatic heart attack. A heart attack, medically known as myocardial infarction, occurs when blood flow to part of the heart muscle is reduced or blocked.

One type is an NSTEMI (non-ST-elevation myocardial infarction). Although it may not produce the classic ECG changes associated with an ST-elevation myocardial infarction, it is still a genuine heart attack and requires medical treatment.

Some heart attacks can also have relatively mild or unusual symptoms. Chest discomfort, breathlessness, nausea, sweating, lightheadedness and pain in the arm, jaw, back or stomach can all occur.

So, if you are having new palpitations together with concerning symptoms, don’t assume it is merely a “mini heart attack” or anxiety. Get medically assessed.

What can be mistaken for heart palpitations?

Not every sensation of movement or fluttering in the chest is necessarily a heart rhythm problem.

People may sometimes interpret:

• Muscle twitching in the chest
• Anxiety-related sensations
• Awareness of a normal heartbeat
• Acid reflux or indigestion
• A strong pulse in the neck
• Breathing-related chest sensations

as a heart problem.

The reverse can also happen: a person may assume that unusual chest sensations are indigestion or anxiety when they actually need cardiac assessment.

Because symptoms overlap, new or concerning chest symptoms should not be diagnosed at home.

Are heart palpitations a warning?

Sometimes they are simply a temporary response to stress, caffeine, dehydration or another trigger.

Sometimes, however, palpitations are the first noticeable symptom of an arrhythmia or another medical problem.

Therefore, palpitations are best thought of as a signal worth understanding rather than automatically a sign of danger.

If they are new, recurrent, worsening or associated with other symptoms, speak with a healthcare professional.

When should you see a doctor for heart palpitations?

Arrange a medical evaluation if:

• Palpitations repeatedly occur
• They are becoming more frequent
• They last longer than a few minutes
• They interfere with daily activities or sleep
• You have known heart disease
• You have a family history of heart problems
• They occur with dizziness or unusual weakness
• You are taking medicines or supplements that may affect heart rate

Your doctor can determine whether you need an ECG, blood tests, echocardiography, Holter monitoring or another investigation.

When is it an emergency?

Seek emergency medical care if palpitations do not settle or occur with chest pain/pressure, significant shortness of breath, fainting or severe dizziness.

Heart attack symptoms can include chest pressure or pain, discomfort in the arms, back, neck or jaw, breathlessness, sweating, nausea and lightheadedness.

Can normal people get heart palpitations?

Yes. Absolutely.

Healthy people can experience occasional palpitations. They can happen during stress, after exercise, after consuming caffeine, during periods of poor sleep or simply because of an occasional premature heartbeat.

The presence of palpitations alone does not mean that someone has heart disease. At the same time, recurrent or unexplained symptoms should be assessed rather than automatically attributed to anxiety.

Frequently asked questions about heart palpitations

Should I worry about heart palpitations?

Occasional, brief palpitations without other symptoms are often harmless. However, recurrent, prolonged or worsening palpitations should be evaluated. Palpitations with chest pain, breathlessness, fainting or severe dizziness require urgent medical attention.

How long do palpitations usually last?

Most episodes last seconds or a few minutes, although they can sometimes last longer. The duration, frequency and accompanying symptoms are more important than one fixed time limit.

Can drinking water stop heart palpitations?

Water can help if dehydration is contributing to the episode. It will not stop every cause of palpitations, particularly those caused by an arrhythmia or another medical condition.

What should I drink when I have palpitations?

If you may be dehydrated, water is a sensible choice. Avoid caffeine and energy drinks if they trigger your symptoms. There is no special drink that universally stops palpitations.

What vitamin deficiency causes palpitations?

There isn’t one specific vitamin deficiency responsible for most palpitations. Electrolyte abnormalities involving magnesium, potassium or calcium, as well as anaemia related to iron deficiency, can contribute in some people.

Can too much vitamin D cause heart palpitations?

Excessive vitamin D supplementation can cause dangerously high calcium levels and, in severe toxicity, an irregular heartbeat. High-dose vitamin D should therefore only be taken when medically appropriate.

Is it okay to sleep while palpitating?

A brief, mild palpitation without warning symptoms is usually not an emergency. But persistent palpitations or palpitations accompanied by chest pain, breathlessness, fainting or significant dizziness should be assessed urgently rather than ignored.

What’s the best position to stop palpitations?

There is no position guaranteed to stop palpitations. Sitting comfortably, resting and breathing slowly may help if stress is contributing. A change of position may make the sensation less noticeable but does not treat an underlying arrhythmia.

How do I check my heart palpitations?

Keep a record of the timing, duration, triggers and accompanying symptoms. A doctor may use an ECG, Holter monitor, blood tests, echocardiogram or other investigations to determine the cause.

What foods should I avoid if I have heart palpitations?

There is no universal list. Caffeine, alcohol, energy drinks and sometimes large, rich or spicy meals can trigger symptoms in susceptible people. Keeping a food and symptom diary can help identify individual triggers.

What are mini heart attacks?

“Mini heart attack” is an informal term rather than a specific diagnosis. A heart attack is still a serious medical condition even when symptoms are mild. NSTEMI is one recognised type of heart attack and requires medical evaluation and treatment.

Final thoughts

Heart palpitations can feel frightening, but the sensation itself does not necessarily mean that something is wrong with your heart. Stress, caffeine, dehydration, exercise, lack of sleep and other everyday factors can cause temporary palpitations, while medical conditions such as anaemia, thyroid disorders and arrhythmias can also be responsible.

The key is to look at the bigger picture: how often are the palpitations happening, how long do they last, what triggers them, and are there other symptoms?

If they keep returning or are becoming more frequent, an ECG and appropriate medical evaluation can help identify the cause. And if palpitations occur with chest pain, significant breathlessness, fainting or severe dizziness, seek emergency medical attention.

For people in Kolkata experiencing recurrent or unexplained palpitations, a cardiac evaluation can help determine whether further tests such as an ECG, echocardiogram or rhythm monitoring are appropriate.

Medical note: This article is intended for health education and does not replace an examination or diagnosis by a qualified healthcare professional. Persistent, recurrent or concerning heart symptoms should be medically evaluated.

To consult a Cardiologist at Sparsh Diagnostic Centre, call our helpline number 9830117733.

#BhaloTheko

Disclaimer:

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.