Heart Palpitations

What is it?

Palpitations are an abnormal awareness of the heartbeat. They are one of the most common cardiac complaints in primary care, yet most are benign — caused by premature beats (PACs or PVCs), anxiety, caffeine, or dehydration. Serious causes include atrial fibrillation, supraventricular tachycardia (SVT), ventricular tachycardia, and long QT syndrome. The clinical history — onset, duration, associated symptoms (chest pain, syncope, dyspnea), and triggers — combined with a resting ECG guides workup. An event monitor or Holter monitor captures the rhythm during symptoms.

Common causes

When to see a doctor

• 1Palpitations with chest pain, shortness of breath, or fainting — call 911
• 2Palpitations lasting more than a few minutes or recurring frequently
• 3Racing heart with a very fast or irregular rhythm you can feel
• 4Palpitations in someone with known heart disease or family history of sudden cardiac death
• 5Palpitations with lightheadedness or near-syncope
• 6New palpitations after starting a new medication

What you can do

• ✓Reduce caffeine (coffee, energy drinks, tea) — a major benign trigger
• ✓Stay well hydrated; dehydration increases ectopic beats
• ✓Try the Valsalva maneuver (bear down as if having a bowel movement) for SVT episodes
• ✓Avoid alcohol and stimulant supplements
• ✓Practice stress reduction: deep breathing, meditation, and regular exercise
• ✓Track triggers in a log to identify patterns before your provider appointment

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions