Heart Palpitations: What They Mean and When to Worry

Heart palpitations can feel like flutters, skipped beats, pounding, or a sudden “thump” in your chest or throat. 

Many adults experience them—in fact, they’re the second most common reason people are referred to cardiologists.

While they can come and go without signaling a serious problem, some palpitations can be a sign of an abnormal heart rhythm or an underlying cardiovascular issue. Knowing the difference can help you stay safe and get the right care when you need it.

What Are Heart Palpitations?

Heart palpitations are sensations of an irregular, racing, or forceful heartbeat. They can occur during rest, daily activities, exercise, or even while lying down. 

Many are triggered by normal rhythm variations or external factors such as stress, caffeine, or dehydration.

It’s important to remember that palpitations are a symptom, not a diagnosis. Understanding when and why they happen provides valuable clues for your doctor.

Be ready when you visit the doctor: Track the time of day, frequency, and possible triggers of your episodes to share when you book your cardiovascular evaluation.

What Causes Heart Palpitations?

Heart palpitations aren’t always cause for concern. Sometimes, lifestyle factors can enhance your awareness of your heart beating.

Common non-serious triggers include:

• Stress or anxiety
• Caffeine or energy drinks
• Alcohol or nicotine
• Dehydration
• Lack of sleep
• Certain cold or allergy medications

However, sometimes they can indicate an underlying medical cause, such as:

• Thyroid disorders
• Anemia
• Electrolyte imbalances
• Arrhythmias (irregular heart rhythms)
• Structural heart disease

If you notice new or frequent palpitations, a conversation with your doctor is the best way to understand what’s going on.

Heart Palpitations After Eating

Large meals consisting of foods high in sugar, salt, or refined carbohydrates can cause your heart to race. Sensitivities to ingredients like caffeine or food additives may also trigger palpitations. 

If you suspect this might be the case, it’s a good idea to keep a food journal to identify patterns and share your notes with your provider.

Heart Palpitations After Exercise

It’s normal for your heart rate to increase during physical activity, but palpitations after exercise can indicate:

• Dehydration
• Low electrolytes
• Overexertion

If you have a history of heart disease or irregular rhythms, report any exercise-related palpitations to your doctor.

Heart Palpitations at Night

Palpitations often feel more noticeable when you’re lying down. This may be due to:

• Increased awareness of your heartbeat in quiet environments
• Stress or anxiety at bedtime
• Caffeine or alcohol consumed in the evening

Heart Palpitations During Pregnancy

Many pregnant women experience palpitations due to hormonal changes, increased blood volume, and/or emotional stress or fatigue. 

Most of the time, they are harmless, but persistent or intense palpitations may signal anemia, thyroid imbalance, or heart problems.

Note: Expectant mothers should contact their OB-GYN or cardiologist if palpitations occur with dizziness, shortness of breath, or chest discomfort.

When to Worry About Heart Palpitations

Occasional palpitations are usually normal, but symptoms that are frequent, severe, or accompanied by other warning signs require medical attention.

Seek care if you experience palpitations along with:

• Chest pain or tightness
• Dizziness or fainting
• Shortness of breath
• Fatigue or weakness
• A rapid or irregular heartbeat that lasts more than a few minutes

These symptoms can indicate arrhythmias or underlying heart disease.

If symptoms worsen suddenly, call your doctor or visit the emergency department right away.

Red Flags That Require Immediate Attention

Contact emergency services if palpitations occur with:

• Chest pain radiating to the arm, jaw, or back
• Fainting or near-fainting episodes
• Sudden shortness of breath
• Severe dizziness

These may be signs of:

• A heart attack
• Atrial fibrillation
• Ventricular arrhythmias
• Other dangerous cardiac events

Prompt treatment can save your life.

How Heart Palpitations Are Diagnosed

Your provider will start by taking a detailed medical history. They will review your triggers and symptoms (this is where your symptom journals can be particularly helpful), conduct a physical exam, and possibly administer an electrocardiogram (ECG).

Depending on your results, you may need further testing to help pinpoint the cause and rule out serious conditions early. They may include:

• A heart monitor
• An echocardiogram
• A stress test
• Blood tests to check thyroid function, anemia, or electrolyte levels

Treatment Options for Heart Palpitations

Treatment depends on what’s causing your symptoms. Many people simply need lifestyle adjustments like:

• Reducing caffeine or alcohol
• Managing stress
• Improving hydration
• Getting consistent sleep
• Avoiding over-the-counter stimulants

If your provider uncovers an underlying issue like anemia, thyroid imbalance, or a heart rhythm disorder, they will work with you to tailor a personalized treatment plan.

Schedule Your Heart Evaluation at Cardiovascular Center

Heart palpitations can range from harmless to serious, and the only way to know for sure is to get expert care. 

At The Cardiovascular Center of Florida, we offer comprehensive testing, clear answers, and personalized treatment for every patient.

If you’re experiencing new, frequent, or concerning palpitations, don’t wait.

Schedule your heart evaluation today and take the first step toward peace of mind and better heart health.