I Have Palpitations--What Should I Do? Part I of II

By Lenny Organ • May 9, 2025 • Tags:Heart, Healthy,

I have heart palpitations—What should I do?



Heart palpitations are sensations of an irregular, pounding, or racing heartbeat. You might feel like your heart is:

  • Fluttering
  • Racing
  • Pounding
  • Skipping a beat
  • Beating too fast
  • Beating too slow


Types of Palpitations:

  • Tachycardia: This refers to a rapid heart rate, typically defined as a resting heart rate above 100 beats per minute.
  • Ventricular Extrasystoles (PVCs): These are extra heartbeats that originate from the lower chambers of the heart (ventricles). They can feel like a "skipped beat" followed by a strong thump.


Possible Causes of Palpitations:

  • Stress and Anxiety:
  • Stress, anxiety, and strong emotions can trigger the release of hormones that increase heart rate.
  • Caffeine and Stimulants:
  • Caffeine, nicotine, and other stimulants can also increase heart rate and cause palpitations.
  • Dehydration:
  • Dehydration can lead to electrolyte imbalances, which can affect heart rhythm.
  • Medications:
  • Certain medications, such as decongestants, asthma medications, and some over-the-counter drugs, can cause heart palpitations as a side effect.
  • Medical Conditions:
  • In some cases, palpitations can be a symptom of underlying medical conditions, such as:
  • Hyperthyroidism: Overactive thyroid gland
  • Heart disease: Coronary artery disease, heart failure, heart valve problems
  • Arrhythmias: Irregular heart rhythms
  • Iron deficiency anemia

When to See a Doctor:

  • Frequent or prolonged palpitations
  • Palpitations accompanied by chest pain, shortness of breath, dizziness, fainting, or lightheadedness
  • Palpitations that occur after a recent heart attack or surgery


While often triggered by benign factors, heart palpitations can sometimes indicate underlying heart problems. Here are some common causes: 

  • Lifestyle Factors:
  • Stress and Anxiety: Emotional stress, anxiety, and panic attacks can significantly trigger palpitations. 
  • Strenuous Exercise: Intense physical exertion can cause temporary heart rate increases, which may feel like palpitations. 
  • Caffeine and Stimulants: Caffeine, nicotine (in tobacco products), and other stimulants can overstimulate the heart and cause palpitations. 
  • Alcohol: Excessive alcohol consumption can affect heart rhythm and cause palpitations. 
  • Dehydration: Dehydration can lead to electrolyte imbalances, which can disrupt heart rhythm. 
  • Hormonal Changes:
  • Pregnancy: Hormonal fluctuations during pregnancy can affect heart rate and rhythm. 
  • Menopause: Hormonal changes during menopause can also contribute to palpitations. 
  • Medications:
  • Certain medications, such as:
  • Bronchodilators: Used to treat asthma 
  • Decongestants: Found in cold and allergy medications 
  • Stimulants: Used to treat ADHD 
  • Some antidepressants: Can cause palpitations as a side effect. 
  • Always consult your doctor about potential side effects of any new medication.
  • Underlying Medical Conditions:
  • Heart Disease:
  • Coronary Artery Disease: Narrowing of the arteries supplying blood to the heart.
  • Arrhythmias: Irregular heart rhythms, such as atrial fibrillation. 
  • Heart Failure: Weakening of the heart muscle. 
  • Thyroid Disorders:
  • Hyperthyroidism: Overactive thyroid gland. 
  • Anemia: Iron deficiency anemia can cause palpitations. 
  • Electrolyte Imbalances: Imbalances in minerals like potassium or magnesium can affect heart rhythm. 

 

Preventing Heart Palpitations:

  • Healthy Lifestyle:
  • Balanced Diet: Focus on a diet rich in fruits, vegetables, whole grains, and lean protein. Limit processed foods, saturated fats, and trans fats. 
  • Hydration: Drink plenty of water throughout the day to stay hydrated. 
  • Moderate Alcohol Consumption: Limit alcohol intake or abstain entirely.
  • Smoking Cessation: Quit smoking completely.
  • Regular Exercise: Engage in regular physical activity, such as brisk walking, jogging, swimming, or cycling. 
  • Stress Management:
  • Relaxation Techniques: Practice relaxation techniques such as deep breathing exercises, meditation, yoga, or tai chi. 
  • Stress-Reducing Activities: Engage in activities that help you relax and de-stress, such as spending time in nature, listening to music, or pursuing hobbies. 
  • Medication Review:
  • Consult with your doctor: If you are taking any medications that may cause palpitations as a side effect, discuss potential alternatives or dosage adjustments with your doctor.
  • Regular Checkups:
  • Consult a healthcare professional: If you have a history of heart disease or experience frequent or severe palpitations, schedule a consultation with a cardiologist or your primary care physician for a thorough evaluation and appropriate management.