What Do Heart Palpitations Feel Like?
Heart palpitations are an increased awareness of your heartbeat. Normally, most people do not notice every heartbeat. During a palpitation, however, your heartbeat may suddenly feel unusually noticeable or different.
You may describe the sensation as your heart:
- racing or beating faster than usual;
- pounding or beating very forcefully;
- fluttering in your chest;
- flip-flopping;
- skipping a beat;
- having an extra beat; or
- beating irregularly.
Although the sensation often seems to come from the chest, some people feel palpitations more clearly in the neck or throat.
How Long Can Heart Palpitations Last?
Palpitations may last only a few seconds, continue for several minutes or occasionally last longer. They may happen once, recur periodically or become frequent enough to interfere with daily life.
The duration alone does not tell us the cause. What matters is the complete picture: how the episode begins, how long it lasts, how often it happens, what you were doing at the time and whether other symptoms occur with it.
Symptoms That May Occur With Palpitations
Palpitations may occur by themselves. In other situations they may occur together with symptoms such as:
- lightheadedness or dizziness;
- weakness;
- shortness of breath;
- unusual sweating;
- chest discomfort;
- near-fainting; or
- fainting.
These associated symptoms are important because they can help your healthcare professional determine how urgently your palpitations need to be evaluated.
When Heart Palpitations Need Urgent Attention
Seek urgent medical help if palpitations are persistent or occur with concerning symptoms such as chest pain or pressure, significant difficulty breathing, fainting, severe lightheadedness or a feeling that you are about to pass out.
New or rapidly worsening symptoms also deserve medical assessment. If you believe you may be having a medical emergency, contact your local emergency service.
What Can Cause Heart Palpitations?
Palpitations have many possible causes. Some are temporary triggers, while others are medical conditions that may need investigation.
Common triggers and possible causes include:
- stress, anxiety, fear or panic;
- physical exercise;
- caffeine;
- alcohol;
- nicotine;
- pregnancy or hormonal changes;
- dehydration;
- fever;
- anemia;
- an overactive thyroid;
- electrolyte abnormalities;
- some medicines, including certain stimulants and decongestants;
- recreational stimulant drugs; and
- heart rhythm disorders such as atrial fibrillation or other arrhythmias.
Because very different conditions can produce a similar sensation, the feeling of palpitations by itself usually cannot identify the cause.
Do Heart Palpitations Mean You Have an Arrhythmia?
No. A palpitation is a symptom — something you feel. An arrhythmia is an abnormality in the heart’s electrical rhythm. The two are related, but they are not the same thing.
Some people feel palpitations during an arrhythmia. Others have palpitations while their heart rhythm is normal. Conversely, some abnormal heart rhythms may cause few or no noticeable symptoms.
This is why it is better not to diagnose the cause based only on what the heartbeat feels like.
How Do Doctors Evaluate Heart Palpitations?
Evaluation usually begins with your medical history and a description of the episodes. Your healthcare professional may ask when the palpitations started, how often they occur, how long they last, whether they start and stop suddenly, and whether you notice any triggers.
An electrocardiogram (ECG or EKG) can provide important information about the heart’s electrical rhythm. However, a short ECG records only the period during which it is performed. If your palpitations come and go, the ECG may be normal between episodes.
Depending on your symptoms and medical history, your clinician may consider longer rhythm monitoring, such as a Holter monitor or event monitor. Blood tests or other investigations may also be appropriate when conditions such as anemia, thyroid disease or electrolyte problems are suspected.
What I Want You to Notice Before Your Appointment
If you experience palpitations, try to remember what was happening when they started. Note approximately how long they lasted and whether the heartbeat felt fast, forceful, irregular or as though a beat was skipped.
It can also help to record:
- the time of day;
- what you were doing;
- recent exercise;
- caffeine or alcohol intake;
- medicines or supplements;
- stress or anxiety;
- your pulse or smartwatch reading, if available; and
- any dizziness, chest discomfort, breathlessness or fainting.
These details can be more useful to your doctor than simply saying, “My heart felt strange.”
When Should You Arrange a Medical Appointment?
Arrange an evaluation if your palpitations keep returning, are becoming more frequent, last longer than they used to, interfere with daily activities or are new and unexplained.
Evaluation is particularly important if you already have heart disease or another condition that may affect your heart rhythm.
Most Asked Questions
Can heart palpitations happen while resting?
Yes. Palpitations can occur during exercise, normal daily activities or while resting. Many people notice them more clearly at night or while lying quietly because there are fewer distractions.
Can anxiety cause heart palpitations?
Yes. Stress and anxiety can increase awareness of the heartbeat and may trigger faster or more forceful beating. However, new or persistent palpitations should not automatically be assumed to be anxiety without considering other causes.
Are skipped beats always dangerous?
No. Occasional premature beats can occur in people without serious heart disease. But frequent, worsening or symptomatic episodes deserve evaluation, especially when they occur with dizziness, fainting, chest discomfort or breathlessness.
Can an ECG always find the cause?
No. An ECG is an important test, but intermittent palpitations may not occur during a short recording. In some cases, longer heart-rhythm monitoring is needed to correlate symptoms with the heart rhythm.
Related Heart Palpitation Guides
As we rebuild Heart-Palpitation.com, this page will connect to detailed guides about anxiety and palpitations, pregnancy, caffeine, thyroid disease, palpitations at night, dizziness, chest pain and other common situations.
Medical References
- American Heart Association — How serious are heart palpitations?
- Cleveland Clinic — Heart Palpitations: Symptoms, Causes & Treatment
- Mayo Clinic — Heart palpitations: Symptoms and causes
- NHS — Heart palpitations
Medical information notice: This page provides general educational information and is not a substitute for individual diagnosis, treatment or emergency medical care.