Palpitations – Causes and Management

What Are Palpitations?

Feeling or perceiving your heartbeats is referred to as palpitations. Normally heartbeat is not felt.

They may be felt when they are very rapid, or very loud (stronger than normal) or when they are irregular in their rhythm.

Strong beats feel like a pounding sensation in your chest area.

Symptoms of Palpitations

  • Pounding feel in your chest wall
  • Beating too fast
  • Irregular pulse
  • Uneasiness
  • Dizziness

There may be accompanying symptoms, which clue towards the root cause of having palpitations. They include-

Discomfort or pain in the chest, shortness of breath, gastric upsets, vertigo or feeling severely dizzy emotional instability etc.

Depending upon the root cause of getting palpitations, you may have some accompanying symptoms too.

Causes of Palpitations

Palpitation is a general symptom, and may occur in many common medical conditions. A careful physical examination, taking into account other symptoms would reveal the root cause of getting palpitations.

Though the symptom is of the heart, the cause may belong to the heart or may be from outside this organ.

Anxiety Palpitations

Anxiety, intense happiness or grief. Emotional stress of any type may give you palpitations. Such palpitations are usually transient, and subside as the trigger emotions get better. However, there may be some cases where the triggers are chronic and palpitations persist for long durations.

Such long standing cases need to be tackled by medicines.


Vigorous amount of exercises may give you fast heart beats. This is a common experience after running or exercising in the gym for longer time periods.Resting for a while may stabilize heart rhythms.

Hypermetabolic States

Medical states where rate of metabolism is fast. This may include states of fever, hyperthyroidism, or when taking some hormonal pills for muscle building.


Too much intake of stimulants, like tea, tobacco, coffee etc.

Common cough medications have stimulants as their ingredients. This may increase the rate of heart beats temporarily.

This class of medication includes medicines used in asthma.


Conditions like anemia may give faster heart beats. This is because low iron levels lead to poor oxygen carrying capacity of blood. So, more blood needs to be pumped to meet the body needs. Therefore, the heart beats faster.

Causes Related to the Heart

Another reason for getting palpitations is having some heart trouble. A diseased heart or the one progressing towards failure may start producing irregular beats. This is called arrhythmia. It may present as irregular or abnormal heart rhythms. Beats may be too fast but regular or absolutely irregular.


Hypertension is another cause of palpitations. This happens because heart has to push stronger to pump out the blood. So the beats are louder. These louder heart beats may be perceived by the person.

Palpitations After Eating

Commonly, people complain about hearing their heart beats after eating food. This may happen in the following conditions-

After over consumption of food or having adequate food after a long time, the stomach requires more blood to digest it. So, the heart beats faster to meet this increased demand.

If you take more of stimulants, like tea or coffee, in your meals, they may stimulate the heart to beat faster and give palpitations.

Palpitations When Nearing Menopause

Menopause is a state where the female hormones are fluctuating rapidly. These hormonal fluctuation cause the heart to beats faster. Women commonly complain of pounding heart, particularly when they lie down in bed.

Accompanying this symptom are hot flushes and sweating.

Treating Palpitations

Do not ignore your palpitations. Get evaluated by a doctor to go to the root cause  of having palpitations.

Most cases do not require medical treatment. Cutting down on stimulants from food or managing anxiety due to stress may let this symptom subside with time.

In other cases, an ECG needs to be done to rule out any cardiac (heart related) cause. The heart condition may then be accordingly treated.

Medical Advice (Q&As) on “What Causes Palpitations?

  1. Alex

    Greetings, I have been experiencing heart palpitations associated with minor left sided chest pain and left arm numbness off and on for about a year. Sometimes I also experience left sided neck tightness and pain near my jawline. The heart palpitations and other symptoms usually resolve themselves in a day or two. I’m 35 y/o approx 150 lbs, 5’10 in height and don’t have any major medical conditions besides asthma nor any history in my family of heart disease, strokes, high blood pressure, or heart attacks.

    I do drink heavily (at least 3-4 days out of the week) and use cocaine approximately every other weekend or so. Recently I went on a drinking binge with half a gram of cocaine for about 4 days straight. I started to experience all of the said symptoms above but they felt much worse this time with hot flashes, sweating, and abdominal discomfort/nausea. My resting heart rate is at approx 64-74 but I was at 130 during this period. I waited a couple of days and the symptoms for the most part went away but I noticed that when at rest my heart rate was normal (64-74) but when I got up to walk or do anything basic like take a shower, my heart rate would spike to 120-130, I’d get jittery and feel a bit dizzy.

    I went to the ER where they checked my blood troponin levels, chest x-ray, and EKG. They said everything checked out normal and they couldn’t see anything wrong with my heart. My heart palpitations aren’t bounding as hard as they were before but that’s only when I’m at rest. If I stand up, or walk, or do anything which doesn’t require any real exertion, my heart rate will jump back up anywhere around 100-130. I am waiting to get my health insurance back to be able to see my Cardiologist who has evaluated me before approximately 7 months ago with an ultrasound on my heart and a stress test which all came out fine.

    What could be causing these heart palpitations upon standing, left arm numbness, intermittent chest pain, neck tightness, etc? My resting heart rate right now is usually at 80. Is it just taking a while longer than normal to recover from the stress that I’ve put on my heart or is there something more serious underlying that they haven’t picked up yet?

    Thanks for the reply in advance.

      1. Alex


        I went to my Cardiologist and explained my symptoms. He did an EKG, echocardiogram, and stress test on me. He said everything checked out fine except it took a little longer than normal for my heart rate to go down after the stress test. He said he had no explanation as to why I’m experiencing intermittent chest pain with heart palpitations along with the left arm numbness and fatigue. Any ideas on what could be going on?


          1. Buddy M.D. Post author

            If you continue to get palpitations, you may need to go for a 24 hour holter study of the heart. This would objectively assess how much is the beat variation of your heart beats.

  2. Sola

    Hi, can anxiety cause strong heart beats ( felt in throat and chest) with normal heart rate (60-70bpm)?
    I sometimes wake up at night feeling that but if i take my blood pressure it’s normal (92/69) and pulse rate is 55bpm. My dr said anxiety and panic attacks and gave axniety med. mostly thses palpitations are at night but sometimes i feel the beats at daytime ( with ~72bpm).
    Thank you!

    1. Buddy M.D. Post author

      Anxiety may cause strong heart beats. However, there are other conditions too. You may get a thyroid profile done. Let us know the results.

      1. Sola

        Hello, I had a blood test to rule out anemia and thyroid. All came normal. Even had an EKG that was normal. The cardiologist said the culprit is stress and to just forget about it because I tend to hear them more when alone or concentrating on that. I just don’t want to take any anxiety medication or become dependent on that.
        What ways can we reduce anxiety to get rid of these palpitations?


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