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What Causes Heart Palpitations, and When Should You See a Doctor?

September 28, 2023

Maybe you’re mid-workout, mid-cocktail, or just lounging on the couch watching your favorite show. Suddenly, it feels like you’ve swallowed a bass speaker. What’s behind the pounding, racing sensation of heart palpitations — and should you be worried?

We asked Moulin Chokshi, MD, to explain.

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What do heart palpitations feel like?

Some people notice it first in their throat or neck. For other people, it’s in the chest. The sensation can be a bit different for each person, but you’ll probably know it when you feel it.

“Palpitations can feel like a fluttering, pounding, or racing heart, or the feeling that your heart has skipped a beat,” says Dr. Chokshi.

What exactly is going on in my heart?

In simplest terms, something has happened to make your body either speed up your heart rate or you’re experiencing extra heart beats.

The technical label is usually one of these:

  • Sinus tachycardia: The normal heart rhythm, but at a faster rate
  • Premature atrial or ventricular contractions: An extra heart beat
  • Atrial fibrillation: Irregular heart beat

For most people, heart palpitations are from one of the first two, and generally harmless (more on that below).

> Related: 8 Signs You Might Have a Heart Arrhythmia

What’s causing my palpitations?

“In most cases, palpitations are a healthy heart’s normal response to some outside factor,” says Dr. Chokshi.

There are a number of possibilities:

  • Stress
  • Physical activity
  • Dehydration
  • Caffeine
  • Alcohol
  • Tobacco
  • Recreational drugs
  • Certain medications
  • An infection like the flu or COVID-19

When should I see a doctor about heart palpitations?

“Although palpitations can make patients feel anxious, they are not necessarily dangerous,” says Dr. Chokshi.

For most people, palpitations don’t indicate a heart problem. They’re more of a reminder to look at your lifestyle habits — for example, do you need to work on stress management, or focus on drinking more fluids?

That said, if your heart palpitations are accompanied by dizziness, fainting, or severe shortness of breath, see your primary care provider right away or go the Emergency Department.

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Anything else to keep in mind?

If your heart palpitations are bothering you, or become a regular occurrence, schedule a visit with your healthcare team. Ideally, show up to this appointment with a journal in hand, filled with notes about when and how your heart feels funny.

“It’s important to document how often you have palpitations, as well as any accompanying symptoms, so that your doctor can best diagnose what’s causing it,” says Dr. Chokshi.

A heart expert can run tests to rule out any underlying problems.

With any luck, your heart palpitations are nothing to worry about — and you can return to your regularly scheduled programming.