Heart Palpitations: Symptoms Causes Diagnosis and Treatment

Heart palpitations are a sensation that many people experience at least once in their lives. They are often described as an “extra beat,” a “pause,” or a “brief stop” in the heartbeat. Although usually harmless, this sensation can cause discomfort or concern, especially when it occurs frequently or alongside other symptoms. In most cases, the cause is benign, but sometimes palpitations may signal an underlying heart rhythm disorder that requires medical evaluation.

What Are Heart Palpitations

Heart palpitations are a subjective sensation of an irregular heartbeat. They most often occur because of premature beats known as extrasystoles, which disrupt the normal rhythm of the heart. After such a beat, there is a brief pause, and the following heartbeat may feel stronger. Many people describe this moment as a “skip.” In healthy individuals, these episodes are usually temporary and harmless, but if they occur frequently, they may require medical evaluation.

How Heart Palpitations Feel

Symptoms can vary from person to person. Some people notice only mild discomfort in the chest, while others feel a strong “thump” or an irregular pulse. Additional sensations may include:

• a brief pause in the heartbeat,
• fatigue or dizziness,
• shortness of breath,
• and chest discomfort.

Episodes often last only a few seconds and may disappear on their own. However, if palpitations occur daily or are accompanied by other symptoms, a cardiology evaluation is recommended.

Most Common Causes of Heart Palpitations

Heart palpitations can have many different causes, ranging from temporary, harmless factors to conditions that require medical attention.

Functional and Everyday Triggers

In most cases, palpitations are caused by temporary, functional factors such as:

• stress and anxiety,
• lack of sleep,
• caffeine, nicotine, alcohol, or energy drinks,
• dehydration and physical exertion.

Metabolic and Hormonal Factors

An irregular heartbeat can be linked to an imbalance of electrolytes such as potassium and magnesium, thyroid dysfunction, anemia, or elevated body temperature.

Cardiac Causes

In people with existing heart conditions, palpitations may indicate a more serious rhythm disturbance. They can occur in cases of:

• coronary artery disease,
• high blood pressure,
• cardiomyopathy,
• heart valve disorders.

Medications and Substances

Certain medications, particularly stimulants, decongestants, and some antidepressants, can cause heart palpitations as a side effect.

When Heart Palpitations Require Urgent Evaluation

Heart palpitations are usually harmless, but immediate medical attention is necessary if you experience:

• chest pain or pressure,
• shortness of breath,
• severe dizziness or fainting,
• a rapid or slow heartbeat that does not subside,
• palpitations in people with known heart disease.

Diagnosis of Heart Palpitations

To determine whether heart palpitations are harmless or a sign of a more serious rhythm disorder, a detailed diagnostic evaluation is required. The first step is a consultation with a doctor, who will assess the frequency and circumstances of the symptoms and then recommend appropriate tests and laboratory analyses.

The most commonly used diagnostic methods include:

• Clinical examination: discussion of symptoms, pulse and blood pressure measurement, and listening to the heartbeat with a stethoscope. This helps the doctor distinguish occasional extrasystoles from rhythm disorders.
• Electrocardiogram (ECG): a recording of the heart’s electrical activity that identifies rhythm abnormalities.
  Holter monitoring: continuous ECG monitoring for 24–72 hours during normal daily activities to detect intermittent episodes of palpitations.
• Echocardiography: ultrasound imaging that evaluates the structure and function of the heart muscle and valves.
• Stress test: ECG monitoring during physical activity on a treadmill or stationary bicycle to assess the heart’s response to exertion.
• Lab tests: assessment of electrolytes (potassium, magnesium), thyroid hormones (TSH), complete blood count, glucose, and lipid profile to rule out metabolic causes.

In cases where there is suspicion of hereditary or structural heart disorders, genetic testing is also recommended:

• Arrhythmia panel: includes analysis of genes associated with inherited rhythm disorders that may cause sudden episodes of palpitations or fainting.
• Cardiomyopathy panel: examines genetic changes that affect the structure and function of the heart muscle and may be responsible for frequent or severe arrhythmias.

By combining clinical examination, instrumental testing, and lab tests, the physician gains a complete picture of heart function and can accurately determine whether palpitations require treatment or only monitoring.

How to Calm Heart Palpitations

In most cases, heart palpitations go away on their own. To help relieve discomfort:

• Stay calm and breathe slowly – taking a few deep breaths helps stabilize the rhythm.
• Avoid caffeine, alcohol, and nicotine – stimulants increase heart sensitivity.
• Drink enough water – dehydration can cause electrolyte imbalance.
• Rest and get regular sleep – fatigue and stress often worsen symptoms.
• Eat lightly – avoid heavy meals and late dinners.

Treatment of Heart Palpitations

In most cases, the goal is to reduce symptoms and address the underlying cause. Treatment depends on diagnostic findings.

• Lifestyle changes – limit caffeine and alcohol, stop smoking, get enough sleep, stay hydrated, manage stress, and eat smaller, earlier meals.
• Addressing underlying causes – correct electrolyte deficiencies if confirmed, regulate thyroid function, treat anemia, and manage reflux or other gastrointestinal issues.
• Medication as indicated – for frequent or bothersome episodes, beta-blockers may be prescribed; other antiarrhythmic drugs are used only under cardiologist supervision.
• Treatment of underlying heart disease – conditions such as hypertension, coronary artery disease, cardiomyopathies, and valve disorders are treated according to current guidelines.
• Mind-body techniques – guided breathing, relaxation exercises, and moderate physical activity adapted to the individual’s condition.
• Interventional procedures – if a specific source of arrhythmia is identified, catheter ablation may be considered; devices such as pacemakers or ICDs are used only when a significant arrhythmia and increased risk are confirmed.

Frequently Asked Questions About Heart Palpitations

Are heart palpitations dangerous during pregnancy?

Usually not. They are most often caused by hormonal changes and increased blood volume. However, if they are accompanied by dizziness, shortness of breath, or chest pain, a medical evaluation is recommended.

Can the stomach cause heart palpitations?

Yes. Bloating, acid reflux, and pressure on the diaphragm can trigger reflex changes in heart rhythm. These symptoms often improve with smaller, more frequent meals and by avoiding late dinners.

Why do heart palpitations occur at night?

During sleep, changes in the nervous system occur, and conditions such as acid reflux or sleep apnea can intensify the sensation of palpitations. If you wake up with a rapid heartbeat or a feeling of paused breathing, Holter monitoring is advised.

Why do heart palpitations occur at rest?

When at rest, the effects of the nervous system and hormonal changes become more pronounced. The most common causes include stress, fatigue, or stimulants such as caffeine and nicotine.

Are heart palpitations dangerous in young people?

Usually not. In young people, they are most often caused by stress, dehydration, or a lack of electrolytes. However, if fainting or a very rapid heartbeat occurs, a medical check-up is necessary.

Can anxiety cause heart palpitations?

Yes. Anxiety and panic attacks can cause sensations of skipping, rapid, or irregular heartbeats, which usually subside once stress and tension decrease.

The Path to a Calm and Steady Heartbeat

Heart palpitations are common and usually harmless, but they can also be a sign that the heart is reacting to stress, fatigue, or an underlying rhythm disorder. It is important not to ignore frequent episodes but to view them as the body’s signal that balance is needed. Maintaining optimal blood pressure, following a healthy diet, and avoiding stimulants help protect the heart from unnecessary strain. Regular check-ups and laboratory tests, which can be done at the IntroLab, help detect changes early and support long-term heart health.