Palpitations are a condition commonly encountered in daily life. The sensation of a suddenly rapid, forceful, or irregular heartbeat may cause anxiety for many people. Many may wonder what causes palpitations—whether it is merely a temporary health issue or a warning sign of a serious disease. Understanding palpitations is therefore important to help you assess yourself and receive timely care.
What are palpitations like?
Palpitations are a sensation of a skipped beat, a pause, or an abnormally rapid and forceful heartbeat. Patients may feel a fluttering sensation or tightness in the throat or chest. Sometimes it may feel like the heart is beating irregularly or missing beats. Although this symptom may occur temporarily for only a few seconds, if palpitations occur frequently, they can affect daily life and may be a warning sign of an internal abnormality that should be evaluated by a doctor.
What can cause palpitations?
An abnormal heartbeat can occur due to various factors, including behaviors, the environment, and underlying conditions. If you want to know what causes palpitations, check the main commonly found causes as follows:
Stress, anxiety, and panic disorder
When the body faces stress, anxiety, or panic disorder, the autonomic nervous system signals the release of more adrenaline than normal. This stimulates a faster heart rate, causing palpitations along with sweating, chest tightness, and shortness of breath.
Exercising or doing overly strenuous activities
With high-intensity exercise or overly strenuous activity, the body must urgently pump blood to supply the muscles. The heart therefore has to work harder by beating faster and more forcefully, which can also lead to palpitations. This is considered a normal bodily reaction and will gradually subside with rest.
Excessive caffeine intake from beverages
Caffeine in tea, coffee, soft drinks, or energy drinks directly stimulates the central nervous system and the heart muscle. If consumed in excessive amounts, it may cause the circulatory system to work faster, leading to palpitations, hand tremors, or insomnia.
Side effects from certain medications and heart-stimulating chemicals
Some medications—such as appetite suppressants, bronchodilators, cold medicines containing pseudoephedrine—as well as smoking and illicit drugs, contain substances that stimulate heart function. This can cause an abnormally rapid heartbeat, resulting in palpitations. Therefore, medications taken regularly can also be one of the causes.
Overactive thyroid leading to hyperthyroidism
An overactive thyroid that produces excessive hormones, or hyperthyroidism, accelerates the body’s metabolism rapidly and continuously stimulates the heart. Patients may therefore experience palpitations, weight loss, easy fatigue, heat intolerance, and sweating more easily than usual.
Arrhythmias and abnormalities of the vascular system
A major medical cause is arrhythmia, leaky heart valves, or acute myocardial ischemia, which can be life-threatening and may lead toheart failure. If you have palpitations along with pain radiating to the back or arm, this is a high-risk warning sign and you should see a doctor immediately.
Which palpitations should prompt a medical checkup?
If you have palpitations that come and go frequently, become more severe, or occur with warning signs such as lightheadedness, dizziness, fainting, shortness of breath, or severe chest tightness/pain—which may indicateheart disease symptoms—you should see a doctor immediately for a thorough diagnostic evaluation to determine the cause.
Diagnostic steps for palpitations by a doctor
To determine what causes palpitations, doctors will assess through a comprehensive diagnostic process to guide treatment appropriate to each individual’s symptoms, as follows:
- Detailed history taking and physical examination: The doctor will ask about the characteristics of palpitations, triggering factors, medication history, underlying diseases, and daily lifestyle behaviors to assess initial risk.
- Electrocardiogram (EKG): A basic test to measure the heart’s electrical activity at that moment. It helps check whether the heart rate and rhythm are abnormal or irregular.
- Continuous ambulatory ECG recording (Holter Monitoring): The patient will take home a device to record heart activity continuously for 24 or 48 hours. This is suitable for people who experience palpitations intermittently.
- Echocardiogram (ultrasound of the heart): Scans the heart structure, heart muscle contraction, and valve function in detail to identify structural abnormalities.
- Laboratory tests (Blood Tests): Blood is drawn to check thyroid hormone levels, blood sugar, and electrolyte balance to identify hidden causes affecting the heartbeat.
Treatment approaches based on the cause of palpitations
Care and treatment for patients with palpitations depend on the individual cause. The doctor will choose methods that address the root cause, as follows:
- Lifestyle modification and avoidance of triggers: If caused by stress, coffee, or alcohol, the doctor will recommend reducing or avoiding them, along with getting adequate rest.
- Medication treatment: Used when palpitations are due to underlying diseases or abnormal internal body function, such as hyperthyroidism with excessive heart-stimulating hormones, or early-stage arrhythmia. The doctor may prescribe medications to control heart rate, antiarrhythmic drugs, or medications to treat the underlying cause to restore heart and hormone function to a balanced level.
- Radiofrequency catheter ablation: Used when the patient has arrhythmia caused by certain areas of heart tissue generating or conducting abnormal electrical signals, and it cannot be well controlled with medication, or to avoid long-term medication use. The doctor uses a catheter to treat the site where the abnormal electrical impulse originates, addressing the cause and reducing the chance that palpitations will recur.
- Implantable medical devices: Used when the patient has severe arrhythmia, an excessively slow heart rate that increases the risk of fainting, or an abnormally fast heart rate that raises the risk of sudden cardiac arrest. The doctor may need to implant a pacemaker or an implantable cardioverter-defibrillator (ICD) to detect and deliver electrical impulses to keep the heart rhythm normal and safe at all times.
Health tips to prevent early risk of palpitations
Preventing and reducing the likelihood of palpitations can start with adjusting daily habits to keep the heart system strong, as follows:
- Manage stress and take care of mental health: Practice meditation, do light exercise, or engage in relaxing activities to reduce autonomic nervous system stimulation.
- Limit stimulant consumption: Reduce tea, coffee, energy drinks, alcohol, and stop smoking.
- Get enough sleep: Allow the body and heart to fully recover, about 7–8 hours per day.
- Avoid self-medicating: Especially appetite suppressants, bronchodilators, or certain cold medicines. Always consult a doctor or pharmacist before using medications.
- Have regular heart health checkups: Especially for those at risk, such as people with a family history of heart disease, older adults, or those with chronic conditions.
Get palpitations checked at Bangkok Heart Hospital
Bangkok Heart Hospital is ready to care for patients with palpitations with effective diagnostic technology and cardiology and vascular specialists. We provide comprehensive treatment planning from initial screening through continuous care, so you receive safe care in accordance with international standards.
Article summary
Palpitations may occur due to non-serious causes such as stress, drinking coffee, or intense exercise, but they can also be an important warning sign of heart disease and other bodily abnormalities. If you suspect you are experiencing palpitations frequently together with lightheadedness, difficulty breathing, or chest pain, you should promptly undergo diagnostic evaluation by a doctor to safely plan long-term heart health care.
Frequently Asked Questions (FAQ) about palpitations
1. What causes palpitations while sleeping at night?
They are often caused by stress, sleep apnea, low blood sugar, sleeping on one’s side increasing pressure in the chest, or drinking tea, coffee, or alcohol in the evening.
2. Is it normal for pregnant women to have frequent palpitations?
It is common because blood volume and hormones in the body change, making the heart pump harder. In most cases it is not dangerous, but if there is easy fatigue or lightheadedness, you should see a doctor for diagnostic evaluation.
3. How are palpitations from panic disorder different from heart disease?
Panic disorder often involves palpitations along with fear, sweating, and a feeling of not getting enough air; it occurs temporarily and can resolve. Heart disease often involves severe chest tightness/pain, pain radiating to the arm/jaw, or fainting.
4. What causes palpitations after meals?
It may occur because the body draws more blood to support the digestive system, or due to eating a large meal; strongly flavored foods; spicy/hot foods; tea, coffee, and alcohol that stimulate the heartbeat.
5. Which type of palpitations should prompt urgent medical attention?
Palpitations accompanied by chest tightness/pain, difficulty breathing, severe dizziness, lightheadedness, fainting, loss of consciousness, or unusually frequent episodes should prompt immediate medical attention.
