Heart Skips A Beat

Heart, skip, palpitations, stress, afib, pvc, caffeine, kathryn whitbourne

What Are Heart Palpitations

Stay hydrated, eat well, and get regular exercise. These components of a healthy lifestyle can also reduce your risk for heart palpitations.

Why Does My Heart Feel Like It Skipped a Beat?

If you feel like your heart has suddenly skipped a beat, it may mean you’ve had a heart palpitation. You may feel that your heart is skipping a beat, fluttering rapidly, or beating extremely hard. You may also feel that your heart is producing heavy, pounding beats.

Palpitations aren’t always harmful, but they can be worrisome if you’ve never experienced them before. For many people, the unusual beats will end and go away entirely on their own. Sometimes, however, medical treatment is necessary to prevent them from occurring again in the future.

When to see a doctor

Most of the time that your heart skips a beat, it’s nothing to worry about. However, some symptoms can be a sign of a more serious condition. If you experience palpitations and any of the following symptoms, you should seek emergency medical attention:

  • chest pain or discomfort
  • severe shortness of breath or difficulty breathing
  • dizziness and nausea
  • fainting

Heart palpitations can happen at any time, but often at times of stress. You may feel these unusual sensations in your chest, neck, or even your throat. Symptoms of heart palpitations are different for everyone who experiences them. For many people, the most common symptoms feel as if your heart is:

  • skipping beats
  • fluttering rapidly
  • beating too fast
  • beating harder than usual

A mild irregular heartbeat from time to time can have a wide variety of causes. They commonly occur:

  • after eating
  • after exercise
  • after COVID-19
  • after excessive alcohol consumption
  • after excessive caffeine consumption
  • at night, or when lying down
  • when sneezing
  • during a headache
  • when pregnant
  • after menopause
  • when you’re congested
  • when you’re under extreme stress, have anxiety, or are emotionally burned out

You may only experience one episode in your life, or you may experience palpitations regularly. Most episodes will end on their own, even without treatment.

The cause of heart palpitations isn’t always known. These harmless heart hiccups can happen from time to time without a real explanation.

Some common causes can be identified in people who have heart palpitations, though. The causes can be divided into two primary categories: non-heart-related causes and heart-related causes.

Non-heart-related causes

While a small heart flutter can happen to anyone, people with a high level of stress and anxiety are at greater risk for experiencing palpitations. The primary non-heart-related causes include:

  • intense emotional feelings, including stress or fear
  • anxiety disorders
  • drinking too much caffeine or alcohol, or consuming too much nicotine
  • use of illegal substances, including cocaine, amphetamines, and heroin
  • hormonal changes as a result of pregnancy, menopause, or menstruation
  • vigorous physical activity, including strenuous exercise
  • some herbal or nutritional vitamins or supplements
  • certain medications, including diet pills, decongestants, cough and cold medicines, and asthma inhalers with stimulants
  • illnesses or conditions, including fever, dehydration, abnormal electrolyte levels
  • medical conditions, including low blood sugar, low blood pressure, and thyroid disease
  • food sensitivities or allergies

Heart-related causes

The primary heart-related causes include:

  • arrhythmia (irregular heart beat)
  • a prior heart attack
  • coronary artery disease
  • heart valve problems
  • heart muscle problems
  • heart failure

In many cases, palpitations are harmless, but they can be worrisome. A cause may be unknown, and tests might not return any results. If you continue to experience palpitations or if you’d like to be sure an underlying problem isn’t causing them, make an appointment to see your doctor.

At your appointment, your doctor will conduct a full physical exam and ask about your medical history. If they suspect something might be causing these symptoms, they’ll order tests. These tests can be used to help identify a cause for heart palpitations:

  • Blood tests. Changes in your blood may help your doctor identify possible problems.
  • Electrocardiogram (EKG). This test records your heart’s electrical signals for a period of time. In some cases, you may have an EKG while you’re exercising. This is known as a stress test or treadmill test.
  • Holter monitoring. This type of test requires you to wear a monitor for 24 to 48 hours. The monitor records your heart the entire time. This longer time frame gives your doctor a broader window of your heart’s activities.
  • Event recording. If the palpitations are too sporadic for continuous monitoring, your doctor may suggest another type of device. This one is worn continuously. You’ll use a handheld device to begin recording as soon as you start experiencing symptoms.
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Treatment for heart palpitations depends on the cause. For most people, palpitations will go away on their own, without any treatment. For others, treating the underlying cause of the palpitations can help stop or prevent them.

Avoid triggers with lifestyle changes

If anxiety or stress leads to the sensation, look for ways to reduce your worry. This may include activities such as meditation, journaling, yoga, or tai chi. If these techniques aren’t enough, work with your doctor to find a medication that can ease symptoms of anxiety.

Cut out problematic food and substances

Drugs, medications, and even foods can lead to palpitations. If you identify a substance that’s causing palpitations or sensitivities, try to remove it from your diet.

For example, cigarette smoking can lead to palpitations. If you discover that you have more heart palpitations when you smoke, stop smoking for a period of time and see if the sensation ends. We reached out to readers for real and practical tips to stop smoking.

Take care of your body

Stay hydrated, eat well, and get regular exercise. These components of a healthy lifestyle can also reduce your risk for heart palpitations.

Find a cause-specific treatment

If your heart palpitations are the result of a condition or disease, your doctor will work with you to find an appropriate treatment. These treatment options may include medications, catheter ablation, or electrical cardioversion.

Heart palpitations aren’t usually a reason for concern. If you experience the sensation of a fluttering, rapid, or pounding heart, know that most people won’t need treatment. The palpitations will likely go away on their own without any lasting issues.

However, if these sensations continue or if you’re worried they may be a sign of an underlying health issue, see your doctor. Tests can help your doctor quickly rule out any possible serious issues so that you can find a diagnosis and a treatment.

Last medically reviewed on February 10, 2022

What Are Heart Palpitations?

A heart palpitation is when you feel a fast-beating, pounding, or skipping heartbeat. Most of the time, there’s no reason to worry. But sometimes palpitations can be signs of trouble.

Many say a palpitation feels like a heaviness in the chest, head, or even the neck. Sometimes there’s a flip-flopping in the chest or the throat, or the heart may stop or skip for a brief second.

Do You Need to Call 911?

The answer is yes when you’re also having shortness of breath, severe chest pain, heavy sweating, and dizziness, or you feel like you’re going to pass out. You might be having a heart attack.

Don’t drive yourself to the hospital. Let an ambulance come to you. Paramedics can begin treatment as soon as they arrive. You’ll get help sooner than if you go to the ER on your own.

Do You Need to See a Doctor?

Yes, if your pulse is more than 100 beats per minute and you’ve not been exercising and don’t have a fever.

Yes, too, if you have:

  • Palpitations coming in groups of three or more, or if they keep happening
  • High cholesterol, diabetes, or high blood pressure — you’re at risk for heart disease
  • New or different palpitations

Possible Causes of Heart Palpitations

  • Stress
  • Exercise
  • Caffeine
  • Alcohol
  • Hormones

How does each of these contribute to heart palpitations?

Stress: When you’re in a stressful situation, your body releases the hormone adrenaline. That temporarily speeds up your heart rate and breathing, and raises your blood pressure. If you’re under pressure for a long time, your heart may continue to beat faster than normal, or trigger extra beats.

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Exercise: Your heart rate rises when you work out hard. So you might feel palpitations before and after exercising, but not during — that’s because you won’t notice the extra heartbeats when your heart rate is up. When you stop working out, your heart rate slows down again, but your adrenaline level stays high. That’s when you may feel your ticker beating extra-fast.

It could be a warning sign of something serious. Call 911 if you also have:

  • Shortness of breath
  • Chest pain
  • Extreme lightheadedness

Caffeine: It’s what doctors call a stimulant. It revs up your heartbeat. You may have more of it in your system than you think. You’ll find caffeine not only in coffee and tea, but also in:

  • Coffee drinks like lattes and cappuccinos
  • Sodas (even some non-cola ones)
  • Energy drinks
  • Chocolate
  • Some over-the-counter cold medications — often the “non-drowsy” formulas

Caffeine causes your brain to release adrenaline, and that speeds up your heart rate. Some people are more sensitive to it than others. But if you had a lot of caffeinated drinks in one day — and you’re also feeling tired and stressed out — you could end up with heart palpitations and extra, early beats.

Alcohol: Drinking raises your odds of having an irregular heartbeat. Heavy drinking, like a binge, can bring on an episode if you haven’t had one before. Wine and liquor are more likely to cause problems than beer.

Hormones: Hormone changes that come with menstruation, pregnancy, and menopause can bring on heart palpitations.

How Do You Figure Out the Cause?

Take notes on what was going on before your palpitations began. Bring the notes with you to your doctor’s appointment.

They may suggest you have an electrocardiogram (also called an EKG). This test shows the electric activity in your heart and its rhythm. This information can help your doctor understand what might be going on.

Having extra, early beats usually isn’t dangerous, but it can be frustrating. It affects some people’s quality of life. But once you know what triggers it, you can take steps to treat it and feel better.

Treating Heart Palpitations

Unless your doctor finds another heart condition, they probably won’t suggest treatment for your heart palpitations.

If your symptoms or condition does require treatment, your doctor will probably try one of these methods:

  • Medications: Antiarrhythmic drugs like beta-blockers and calcium channel blockers are a good starting point. Sometimes, these drugs don’t work as well. You might need stronger antiarrhythmic drugs that directly act on the sodium and potassium channels of the heart.
  • Catheter ablation: Your doctor will thread small wires through your leg veins and into your heart. This will trigger an arrhythmia, and your doctor will identify the area and send energy to cause scars and stop the irregular beat.
  • Electrical cardioversion: The doctor gives your heart a shock to get its rhythm back to normal.

Lifestyle Changes to Prevent Palpitations

The best way to stop palpitations is to make sure they never start:

  • Lower stress. Try relaxation techniques, such as meditation, yoga, or deep breathing.
  • Avoid stimulants. Caffeine, nicotine, certain cold medicines, and even energy drinks can cause an irregular heartbeat.
  • Don’t use illegal drugs. Certain drugs, such as cocaine and amphetamines, can lead to palpitations.

Show Sources

University of Iowa Hospitals & Clinics: “Heart Palpitations: Frequently Asked Questions.”

Main Line Health: “Heart Palpitations: How Common Are They and Should You Worry?”

American Heart Association: “Warning Signs of a Heart Attack;” “What is Atrial Fibrillation?;” and “What’s the link between chronic stress and heart disease?”

National Library of Medicine: “Heart Attack First Aid”and Atrial Fibrillation.”

Johns Hopkins Heart and Vascular Institute: “When to Evaluate Heart Palpitations.”

Brown University Health Promotion: “Caffeine.”

Harvard Health Publications: “Skipping a beat – the surprise of palpitations.”

British Heart Foundation: “Effects of alcohol on your heart.”

Mayo Clinic: “Cardioversion,” “Heart palpitations.”

Johns Hopkins Medicine: “When to Evaluate Heart Palpitations.”

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