Heart Health
Palpitations: Common Causes and When to Worry
A simple guide to why your heart may feel like it is racing, fluttering, pounding, or skipping beats, and when to seek medical help.
Patient information page | Last reviewed: June 2026
The quick answer
Palpitations are when your heartbeat becomes more noticeable. It may feel fast, pounding, fluttery, irregular, or as if it has skipped a beat.
They are common and often not dangerous, especially when they are brief and happen with triggers such as stress, caffeine, alcohol, lack of sleep, fever, or dehydration.
You should seek medical help if palpitations keep coming back, last more than a few minutes, happen with a known heart condition, or come with chest pain, shortness of breath, fainting, or severe dizziness.
- At a glance
- Lifestyle triggers
- Emotional triggers
- Medical causes
- Heart-related causes
- Tests
- Urgent help
Palpitations at a glance
Most palpitations are short-lived. The important questions are: how long they last, whether they are regular or irregular, what triggers them, and whether they happen with other symptoms.
Caffeine, alcohol, stress, poor sleep, fever, dehydration, and heavy exercise.
Note the time, duration, pulse rate, trigger, and any associated symptoms.
Needed if they recur, last longer, or happen with a heart condition.
Chest pain, breathlessness, fainting, or severe dizziness needs urgent care.
1. Lifestyle and diet triggers
Your heart is sensitive to changes in your body. Very often, palpitations are linked to what you have taken in, how much you have slept, or how your body is coping that day.
Caffeine
Coffee, tea, cola, and energy drinks can trigger a faster or more noticeable heartbeat in some people.
Alcohol
Alcohol, or the day after drinking alcohol, can trigger palpitations or irregular beats in some people.
Nicotine and stimulants
Smoking, vaping, nicotine products, some decongestants, and recreational drugs can stimulate the heart.
Large meals
Some people notice palpitations after a large meal, especially with alcohol, high sugar intake, or lying down soon after eating.
2. Emotional triggers
The connection between the brain and heart is strong. Stress, fear, pain, and panic can release adrenaline, which can make the heart beat faster and harder.
Stress and anxiety
A demanding day, a sudden scare, or ongoing worry can make the heartbeat feel more forceful or irregular.
Panic attacks
During panic, the heart can race and the chest can feel tight. This can feel frightening, but new or severe symptoms still need proper assessment.
3. Medical causes outside the heart
Sometimes palpitations are a sign that something else in the body is out of balance.
Dehydration
Low fluid levels, heavy sweating, vomiting, or diarrhoea can make the heart beat faster.
Fever or illness
Your heart rate naturally rises when the body is fighting infection or fever.
Anaemia
Low iron or a low red blood cell count can make the heart work harder to carry oxygen around the body.
Overactive thyroid
An overactive thyroid can speed up body functions and cause palpitations, sweating, tremor, weight loss, or heat intolerance.
4. Heart-related causes
Less commonly, palpitations can come from the heart’s electrical system. These causes are important to identify because some need treatment.
Ectopic beats
Ectopic beats are extra beats. They can feel like a skipped beat, pause, flutter, or a heavier thud. They are common and often harmless, but recurring symptoms should be checked.
Arrhythmias
An arrhythmia means the heart rhythm is too fast, too slow, or irregular. Atrial fibrillation is one example where the top chambers of the heart beat out of rhythm.
5. What tests might my doctor do?
Your doctor will ask what the palpitations feel like, how long they last, whether they are regular or irregular, and whether they happen with chest pain, breathlessness, dizziness, or fainting.
Tests may include:
- Pulse and blood pressure check: to look at heart rate, rhythm, and general circulation.
- ECG: a simple heart tracing that records the electrical rhythm of the heart.
- Blood tests: to check for anaemia, thyroid problems, infection, kidney function, salts in the blood, diabetes, or other causes.
- Holter or event monitor: a portable ECG worn for a day or longer if symptoms come and go.
6. Your action plan
If palpitations happen occasionally, pass quickly, and you otherwise feel well, it can help to look for patterns.
- Reduce caffeine and energy drinks.
- Avoid binge drinking and notice whether alcohol triggers symptoms.
- Drink enough fluids, especially during hot weather or illness.
- Try to improve sleep where possible.
- Keep a diary of timing, duration, pulse rate, triggers, and symptoms.
Arrange a doctor review if palpitations keep coming back, last longer than a few minutes, are new for you, happen during exercise, or worry you.
When to get urgent help
Seek emergency medical help immediately if palpitations happen with chest pain, severe shortness of breath, fainting, collapse, or extreme dizziness.
Do not drive yourself to hospital with possible heart symptoms.
Key message
Palpitations are common and often not dangerous. They can be triggered by stress, caffeine, alcohol, fever, dehydration, medicines, or anxiety.
They still deserve medical review if they keep happening, last longer, occur with a known heart condition, or come with chest pain, breathlessness, fainting, or severe dizziness.
References
- NHS. Heart palpitations.
- Mayo Clinic. Heart palpitations: symptoms and causes.
- American Heart Association. What is an arrhythmia?