Heart palpitations causes range from harmless lifestyle factors to conditions that require medical attention. Palpitations are the awareness of your own heartbeat — a fluttering, pounding, skipping, or racing sensation that may be felt in the chest, throat, or neck. Most people experience them at some point, and the majority of episodes are benign.
1 Visit the heart health and hydration hub for related guides on cardiovascular wellness.
What Are Heart Palpitations?
A palpitation is any abnormal awareness of the heartbeat. The heart normally beats 60–100 times per minute in adults, with each beat coordinated by the heart's electrical conduction system. Palpitations occur when something disrupts this rhythm — speeding it up, slowing it down, adding extra beats, or making the person unusually conscious of an otherwise normal rhythm.
The sensation may last seconds or minutes, may be intermittent or sustained, and can range from a single 'thump' to a prolonged rapid flutter. 1
Common Causes of Heart Palpitations
Lifestyle and Dietary Triggers
The most frequent causes of palpitations are lifestyle-related and pose no long-term cardiac risk. Caffeine is a well-recognized trigger — it stimulates the release of adrenaline and directly affects cardiac electrical activity. High doses from coffee, energy drinks, and supplements can provoke palpitations even in healthy individuals. '2
Nicotine from cigarettes or vaping, stress and anxiety, poor sleep, and vigorous exercise can all induce temporary palpitations. Large meals, particularly those high in sugar or refined carbohydrates, may also cause a brief acceleration in heart rate as blood is redirected to the gut.
Dehydration and Electrolyte Imbalances
Dehydration reduces blood volume, causing the heart to beat faster to maintain adequate circulation. Additionally, fluid loss depletes electrolytes — particularly potassium, magnesium, and sodium — that are critical for regulating the heart's electrical activity. Low potassium (hypokalemia) and low magnesium (hypomagnesemia) are both associated with cardiac arrhythmias and palpitations.
1 See our guide on electrolyte imbalance symptoms and treatment and how dehydration can affect heart disease risk.
Hormonal Changes
Fluctuations in sex hormones — particularly estrogen and progesterone — can influence the heart's electrical system. Palpitations are a commonly reported symptom during perimenopause and menopause, likely related to declining estrogen levels and associated changes in autonomic nervous system tone. Pregnancy increases blood volume and cardiac output substantially, which may also produce palpitation sensations. 3
Medications and Supplements
Several prescription medications and over-the-counter products can cause palpitations as a side effect. Common culprits include decongestants containing pseudoephedrine, some asthma inhalers, thyroid replacement medications (if the dose is too high), stimulant medications for ADHD, and certain antidepressants. Some herbal supplements — including ephedra, ginseng, and high-dose licorice root — have also been associated with cardiac arrhythmias.
Always review any new medication or supplement with a healthcare provider if palpitations develop.
Underlying Heart Conditions
In a smaller proportion of cases, palpitations are caused by structural or electrical abnormalities of the heart. Supraventricular tachycardia (SVT), atrial fibrillation, atrial flutter, ventricular tachycardia, Wolff-Parkinson-White syndrome, and heart valve disorders can all manifest as palpitations. 4
Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are among the most common arrhythmia-related causes. Both usually benign in the absence of structural heart disease, they produce the classic 'skipped beat' sensation.
Anxiety, Stress, and the Heart
The relationship between psychological stress and palpitations is bidirectional. Anxiety activates the sympathetic nervous system ('fight or flight' response), which raises adrenaline levels and directly increases heart rate and force of contraction. People with anxiety disorders frequently report palpitations, and the awareness of an accelerated heartbeat can itself trigger further anxiety — creating a cycle that amplifies symptoms.
Chronically elevated stress hormones can also worsen symptoms; see how to lower cortisol with evidence-based methods for management strategies.
Panic attacks often include a rapid heart rate as a central feature, and people experiencing them commonly fear they are having a heart attack. While anxiety-related palpitations are not dangerous, they can be distressing and significantly affect quality of life. 5
When to See a Doctor
Many palpitations are harmless and resolve on their own, but some warrant prompt medical evaluation. Seek medical attention if palpitations:
- Last more than a few minutes or occur very frequently
- Are accompanied by chest pain, pressure, or tightness
- Cause dizziness, lightheadedness, or fainting
- Occur alongside shortness of breath
- Are associated with significant swelling of the legs or feet
- Develop after a heart attack, cardiac procedure, or in someone with known structural heart disease
- Begin suddenly in someone with no prior history who has not changed diet, medications, or lifestyle
4 Those with hydration-related triggers may also benefit from our guide on how to rehydrate fast with evidence-based methods.
Do not dismiss palpitations that recur without an obvious benign trigger, particularly if any of the above warning signs are present.
Frequently asked questions
Are heart palpitations dangerous?
Most palpitations are benign and caused by lifestyle factors such as caffeine, stress, or dehydration. However, palpitations accompanied by chest pain, fainting, shortness of breath, or those occurring in someone with a known heart condition should be evaluated promptly by a healthcare provider.
Can anxiety cause heart palpitations?
Yes. Anxiety activates the sympathetic nervous system, raising adrenaline and increasing heart rate. This is one of the most common causes of palpitations. Treatment of the underlying anxiety often reduces or eliminates episodes.
What foods and drinks trigger heart palpitations?
Caffeine (coffee, energy drinks, tea), alcohol, high-sugar meals, and some food additives are common dietary triggers. Dehydration from insufficient fluid intake can also provoke palpitations by reducing blood volume and disrupting electrolyte balance.
How are the causes of heart palpitations diagnosed?
A doctor will typically take a medical history, perform a physical exam, and order an ECG. If palpitations are intermittent, a Holter monitor or cardiac event recorder worn over days or weeks can capture episodes. Blood tests check for thyroid disorders, anemia, and electrolyte imbalances.
Can dehydration cause heart palpitations?
Yes. Dehydration reduces blood volume and can shift electrolyte levels — especially potassium and magnesium — which are essential for normal heart electrical activity. Rehydrating with water or an electrolyte solution often resolves dehydration-related palpitations.