What causes your heart to race fast

Non-urgent advice: See a GP if:

You have heart palpitations and:

• they keep coming back or they're getting worse
• they last longer than a few minutes
• you have a heart condition
• you have a history of heart problems in your family

Immediate action required: Call 999 or go to A&E if:

You currently have heart palpitations with any of these symptoms:

• chest pain
• shortness of breath
• feeling faint or fainting

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Information:

If you've had these symptoms but they've now stopped, ask your GP surgery for an urgent appointment, call 111 or get help from 111 online.

Page last reviewed: 07 June 2022
Next review due: 07 June 2025

So what exactly are heart palpitations? Heart palpitations are the sensation that your heart has skipped a beat or added an extra beat. It may feel like your heart is racing, pounding, or fluttering.

You may become overly aware of your heartbeat. You may feel this sensation in your chest, neck, or throat. Your heart rhythm may change during the palpitations.

In most cases, heart palpitations are harmless and resolve on their own without treatment. But in other cases, heart palpitations may be an indication of a more serious underlying condition.

Heart palpations can have a wide range of causes that include strong emotions, medications, and lifestyle factors. In some cases, they can be caused by a medical condition affecting your heart or another part of your body.

Heart palpitations are common. One study estimates that 16 percent of visits to a doctor are because of heart palpitations. They’re also the second most common reason that people visit a cardiologist — a doctor who specializes in the heart.

Possible causes of heart palpitations include:

Lifestyle triggers

• strenuous exercise
• excess caffeine or alcohol use
• nicotine from tobacco products such as cigarettes and cigars
• lack of sleep
• dehydration
• smoking

Emotional or psychological triggers

• stress
• anxiety
• fear
• panic
• shock

Drugs and medications

• over-the-counter (OTC) medications, including cold and cough medications, herbal supplements, and nutritional supplements
• prescription medications such as asthma inhalers and decongestants
• stimulants such as amphetamines and cocaine

Heart conditions

Although heart palpitations can be harmless, they can also be an indication of an underlying heart condition, such as:

• arrhythmia, or an irregular heart rhythm
• abnormal heart valves
• heart disease
• congestive heart failure

Other medical conditions

• hormone changes due to pregnancy or menopause
• overactive thyroid, or hyperthyroidism
• fever
• sleep apnea
• electrolyte abnormalities
• low levels of oxygen or carbon dioxide in the blood
• blood loss
• anemia
• low blood sugar

The cause of heart palpitations can be very difficult to diagnose, especially if the palpitations don’t occur while you’re in the doctor’s office.

To start, your doctor will conduct a thorough physical exam and will likely ask you questions about your:

• physical activity
• stress levels
• health conditions
• prescription medication use
• OTC medication and supplement use
• sleep patterns
• caffeine and stimulant use
• alcohol use
• menstrual history

If necessary, your doctor may refer you to a cardiologist. A cardiologist may order certain tests to help diagnose or rule out certain diseases or heart problems. These tests may include:

• blood tests that check hormone and blood cell levels, as well as potassium and other electrolytes that can affect the rhythm of your heart
• a urine test that measures electrolyte, blood cell, hormone, and blood sugar levels
• a stress test that involves studying your heart while your heart rate is elevated, either by walking briskly on a treadmill or by taking medication that speeds up the activity of your heart
• an echocardiogram that uses sound waves to create live, moving images of your heart
• an electrocardiogram (EKG or ECG) that records the electrical activity of your heart
• a chest X-ray that helps your doctor see if your heart is enlarged
• a Holter monitor which consists of a small machine you wear that records your heart’s rhythm for 24 to 48 hours
• an electrophysiology study that can check your heart’s electrical function
• a coronary angiography that can check how blood flows through your heart

Treatment depends on the cause of your palpitations. Your doctor will need to address any underlying medical conditions.

Sometimes, doctors aren’t able to find the cause. Heart palpations usually don’t require treatment unless your doctor finds they’re caused by an underlying condition.

If your palpitations don’t have a medical cause, you may be able to reduce symptoms by:

• Managing stress and anxiety. Including relaxation techniques in your weekly routine may help reduce heart palpations caused by stress or anxiety. There are many options, but some popular options include:
  • physical activity
  • breathing exercises
  • yoga
  • tai chi
  • meditation
  • biofeedback
• Avoiding stimulants. Try to avoid or minimize your intake of caffeine. Some illegal drugs like cocaine and ecstasy are stimulants that can cause heart palpitations. Also ask your doctor whether any of your prescription medications contain stimulants that could cause heart palpitations.
• Watching your diet. Low blood sugar can increase your risk of heart palpations. Replacing sugar and other simple carbs with complex carbs may help keep your blood sugar levels stable. For instance, try to swap sugary sodas, baked goods, and fruit juice concentrates with whole grains and fresh fruit and vegetables.
• Changing medications. If you think your medications are contributing to your palpitations, talk with your doctor about alternatives. However, don’t stop taking any medication without first talking with your doctor.
• Quitting smoking if you smoke. In a review of studies published in 2018, researchers found evidence that people who smoke are at an increased risk of atrial fibrillation, the most common cause of arrhythmia.

If your doctor or cardiologist feels that treatment isn’t necessary, taking the following steps may help lower your risk of heart palpitations:

• Try to identify your triggers so you can avoid them in the future. Keep a log of your activities, including the foods and beverages you consume, any medication you take, as well as your emotional state, and take note of when you get palpitations.
• If you feel stressed or overwhelmed, try to add relaxation techniques to your daily routine.
• If a medication is causing heart palpitations, ask your doctor if there are any alternatives.
• Limit or stop your intake of caffeine. Avoid energy drinks and coffee.
• Avoid stimulant recreational drugs.
• Don’t smoke or use tobacco products. If you smoke, consider limiting it or quitting.
• Exercise regularly.
• Stick to a nutrient-rich diet.
• Try to prevent your blood sugar from getting too low.
• If you consume alcoholic beverages, minimize your intake.
• Try to keep your blood pressure and cholesterol levels managed well.

Heart palpitations are a common condition. Most of the time, they’re harmless and don’t require medical attention. However, in some cases, they can indicate a potentially serious condition.

If you have an underlying heart condition, it’s important to talk with your doctor about your heart palpitations. If you’re not sure if you have a heart condition, but your heart palpitations happen often or seem to be lasting longer or occurring more frequently, be sure to visit your doctor for a proper diagnosis.