Heart Palpitations Due to Anxiety: Why Anxiety Can Make Your Heart Race
Anxiety can make your heart feel as though it is racing, pounding, fluttering or beating unusually hard. These sensations can be frightening, especially when they appear suddenly.
Anxiety is a common trigger for heart palpitations, but it is important not to assume that every palpitation is caused by anxiety. Arrhythmias and medical conditions such as thyroid disease, anemia, dehydration and medication effects can produce similar symptoms.
Can Anxiety Cause Heart Palpitations?
- Yes. Anxiety, fear and panic can make the heart beat faster or more forcefully and can increase awareness of the heartbeat.
- Stress activates the body’s fight-or-flight response, including sympathetic nervous-system and stress-hormone activity.
- A panic attack can include racing heartbeat, dizziness, sweating, trembling, chest discomfort and shortness of breath.
- Rapid breathing or hyperventilation during anxiety may contribute to lightheadedness, tingling and a sense of breathlessness.
- Anxiety and palpitations can form a feedback loop: anxiety makes the heartbeat noticeable, and worrying about the heartbeat creates more anxiety.
- Recurrent palpitations should not automatically be diagnosed as anxiety without considering cardiac and medical causes.
- Seek urgent medical care if palpitations occur with chest pain, fainting, severe shortness of breath or severe dizziness.
Why Does Anxiety Make Your Heart Beat Faster?
When your brain perceives a threat, your body activates its stress response.
The sympathetic nervous system becomes more active, and stress hormones such as adrenaline prepare the body to respond quickly.
One effect can be an increase in heart rate and force of contraction. This can make each heartbeat much easier to feel.
The result may be a sensation of:
- Racing
- Pounding
- Fluttering
- A strong heartbeat
- Occasional skipped or extra beats
Once the stressful situation passes, the heart rate often gradually returns toward its usual level.
What Do Anxiety Heart Palpitations Feel Like?
Anxiety-related palpitations do not have one unique sensation that distinguishes them from all other palpitations.
They may feel similar to the sensations described in our heart palpitation symptoms guide .
Racing
Your heartbeat may suddenly feel faster than usual during fear, worry or panic.
Pounding
The heart may feel as though it is beating unusually hard against the chest.
Fluttering
Some people describe a fluttering or vibrating sensation in the chest.
Skipped or Extra Beats
Premature beats may feel like a skipped beat, pause or sudden stronger beat.
Throat or Neck Pulsation
Some people notice the heartbeat not only in the chest but also in the neck or throat.
Other Anxiety Symptoms
Sweating, trembling, dizziness, tingling, breathlessness and a feeling of intense fear may occur at the same time.
Why Can Anxiety Make You Feel Dizzy or Short of Breath?
During anxiety or a panic attack, some people begin breathing more rapidly or deeply than the body requires.
This is called hyperventilation. It can contribute to symptoms such as lightheadedness, tingling, chest discomfort and a sense that something is seriously wrong.
If dizziness frequently occurs with your heartbeat symptoms, read our detailed guide to dizziness and heart palpitations .
How Anxiety and Palpitations Can Reinforce Each Other
One of the most frustrating features of anxiety-related palpitations is the cycle they can create.
Learning how to respond to the sensation without immediately interpreting it as danger can be an important part of anxiety treatment once appropriate medical causes have been considered.
How Can You Tell Anxiety Palpitations From an Arrhythmia?
Unfortunately, you cannot reliably diagnose the cause simply from how the heartbeat feels.
Anxiety may produce sinus tachycardia — a normal heart rhythm that has become faster because of the body’s stress response.
But premature beats, supraventricular tachycardia, atrial fibrillation and other arrhythmias can also cause racing, pounding or fluttering sensations.
In some cases, having an unexpected arrhythmia can itself make a person feel anxious.
Can Anxiety Cause PVCs or PACs?
Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are early heartbeats that may feel like skipped beats or strong thumps.
Stress and increased adrenaline can make premature beats more noticeable and may contribute to ectopic activity in susceptible people.
However, not every PVC or PAC should automatically be blamed on anxiety.
If skipped beats are frequent, persistent or associated with other symptoms, discussing them with a healthcare professional is appropriate.
Does Anxiety Cause GERD and Then Heart Palpitations?
Anxiety, reflux symptoms and palpitations can occur at the same time, but the relationship should not be oversimplified.
Stress may worsen the perception of gastrointestinal symptoms, while GERD can cause heartburn and chest discomfort.
However, this does not prove that stomach acid is directly causing an abnormal heart rhythm.
If reflux is a major part of your symptom pattern, read our guide to GERD and heart palpitations .
Chest discomfort accompanied by significant cardiovascular symptoms should not automatically be attributed to anxiety or reflux.
What Can Help Calm Anxiety-Related Palpitations?
If a clinician has already determined that anxiety is an important contributor, several practical strategies may help reduce the stress response.
What Tests Are Needed for Anxiety and Palpitations?
You do not automatically need every cardiac test simply because you have anxiety and palpitations.
Medical History
Your clinician may ask what the heartbeat feels like, when it starts, how long it lasts, what triggers it and whether other symptoms occur.
Physical Examination
Pulse, heart rhythm, blood pressure and other clinical signs may provide important clues.
ECG / EKG
An ECG can identify many abnormal heart rhythms if they are occurring during the recording.
Holter or Event Monitor
If symptoms come and go, longer ambulatory ECG monitoring may help record your heart rhythm during an actual episode.
Selected Blood Tests
Depending on the history, tests may be considered for anemia, thyroid abnormalities, electrolytes or other medical causes.
Further Cardiac Tests Only When Indicated
Echocardiography, exercise testing or specialist investigations may be appropriate if the history, examination or ECG suggests a cardiovascular problem.
How Is Anxiety Treated When It Causes Palpitations?
When anxiety is persistent, recurrent or interfering with everyday life, treating the anxiety itself can reduce both psychological and physical symptoms.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is an established psychological treatment for anxiety and panic disorders.
It can help patients understand and change patterns of thought and behavior that maintain anxiety.
Self-Help & Psychological Support
Structured self-help, psychological support and stress-management strategies may be useful depending on symptom severity.
Medication When Appropriate
For some anxiety disorders, clinicians may recommend medicines such as selective serotonin reuptake inhibitors (SSRIs).
Medication selection depends on the individual diagnosis, other health conditions and potential adverse effects.
Treat Confirmed Arrhythmia Separately
If testing identifies an arrhythmia, treatment depends on the specific rhythm.
Treating anxiety does not replace treatment of a confirmed cardiac disorder.
Anxiety Is a Real Cause — But It Should Not Become a Shortcut Diagnosis
I often see patients who become frightened when they suddenly feel their heart beating hard or fast. That fear can make the heartbeat even more noticeable.
Anxiety may indeed be the explanation, especially when the episodes occur during stress or panic and settle as the patient relaxes.
But I still want to know whether the heartbeat is regular or irregular, how long the episode lasts, whether it happens during exercise, and whether dizziness, chest discomfort or fainting occurs.
We should treat anxiety when anxiety is present, but we should not use the word “anxiety” to avoid investigating a symptom that has important warning features.
When Should You Talk to Your Doctor?
Arrange medical evaluation if your palpitations:
- Are new or unexplained
- Keep returning
- Are becoming more frequent
- Last longer than before
- Feel very fast or clearly irregular
- Occur during exercise
- Wake you repeatedly from sleep
- Occur even when you do not feel anxious
- Are associated with significant dizziness or weakness
- Occur if you already have heart disease or a known arrhythmia
If your palpitations are occurring frequently throughout the day, see our guide to constant heart palpitations .
Do Not Assume Serious Symptoms Are “Just Anxiety”
Seek urgent or emergency medical care if palpitations occur with:
- Chest pain or significant chest pressure
- Fainting or loss of consciousness
- Severe shortness of breath
- Severe dizziness or near-fainting
- Sudden severe weakness
- Rapidly worsening or otherwise severe symptoms
Panic attacks and heart conditions can sometimes share symptoms. If you are uncertain about new or severe chest symptoms, seeking appropriate medical assessment is safer than self-diagnosing a panic attack.
For more information, see our guide to chest pain and heart palpitations .
Anxiety and Heart Palpitations: FAQs
Can anxiety really make your heart race?
Yes. Anxiety can activate the body’s stress response and cause a faster or stronger heartbeat.
How long can anxiety palpitations last?
Duration varies. Palpitations related to a brief stress response may settle quickly, while anxiety can recur and produce repeated symptoms.
Persistent or prolonged episodes should not automatically be attributed to anxiety without appropriate evaluation.
Can anxiety cause skipped heartbeats?
Stress and adrenaline may make premature beats such as PACs or PVCs more noticeable in susceptible people.
Frequent skipped beats deserve evaluation if they are persistent or associated with other symptoms.
How do I know whether my palpitations are anxiety or AFib?
You cannot reliably distinguish them from sensation alone.
Atrial fibrillation may cause a rapid and irregular heartbeat, palpitations, dizziness, breathlessness and anxiety.
An ECG or heart-rhythm monitor can help identify what rhythm is actually present.
Why do palpitations make my anxiety worse?
Feeling an unexpected heartbeat can trigger fear that something dangerous is happening.
That fear can activate the stress response further, creating a cycle of increasing heartbeat awareness and anxiety.
Does slow breathing help anxiety palpitations?
Slow, comfortable breathing can help reduce hyperventilation and may help the body settle during anxiety.
It is not a substitute for medical assessment when symptoms suggest an arrhythmia or another heart condition.
Can anxiety cause palpitations when sitting or lying down?
Yes. Palpitations may occur during rest, and quiet environments can make heartbeat sensations easier to notice.
See our guide to heart palpitations while sitting if this is your main pattern.
Should I take medication for anxiety palpitations?
Treatment depends on whether anxiety is actually the underlying problem and on the type and severity of the anxiety disorder.
CBT, structured psychological approaches and, in selected patients, medications such as SSRIs may be considered with a clinician.
Do not start heart medication, anti-anxiety medication or blood thinners solely because you have palpitations.
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Evidence Used for This Article
- Mayo Clinic. Heart Palpitations: Symptoms and Causes .
- American Heart Association. Heart Palpitations: Causes, Symptoms and When to Worry .
- NHS. Panic Disorder .
- American Heart Association. Symptoms, Diagnosis and Monitoring of Arrhythmia .
- American Heart Association. Premature Contractions: PACs and PVCs .
- NICE. Generalised Anxiety Disorder and Panic Disorder in Adults .