What Causes Heart Palpitations?

The short version

A palpitation is the feeling that your own heartbeat has become noticeable, whether that's racing, pounding, fluttering, or skipping a beat. It's an extremely common sensation, and most of the time the underlying cause is benign: something ordinary temporarily changed how forcefully or irregularly the heart is beating, and you happened to notice it (AHA Palpitations).

The feeling itself doesn't tell you the cause. That's the whole reason capturing an EKG while it's happening is useful: it turns "something felt off" into an actual rhythm strip a clinician can read.

Common, usually harmless triggers

A few things account for a large share of everyday palpitations:

• Caffeine and stimulants. Coffee, energy drinks, and some over-the-counter decongestants can all make the heart beat more forcefully or trigger extra beats.
• Stress and anxiety. The same nervous-system response that makes your palms sweat under stress also speeds up and strengthens your heartbeat.
• Poor sleep. Sleep deprivation is a well-recognized trigger for palpitations in otherwise healthy people.
• Dehydration. Lower blood volume means the heart has to work harder and can beat less predictably.
• Position changes. Standing up quickly can produce a brief, noticeable change in heart rate as blood pressure adjusts.
• Extra beats (premature contractions). A single early beat from the atria or ventricles, followed by what feels like a "skip," is one of the most common palpitation sensations and is frequently harmless on its own (ACC Extra Beats).

Less common causes worth knowing about

Some causes are less common but more clinically significant, which is exactly why a captured EKG matters:

• Atrial fibrillation and other arrhythmias. A true abnormal heart rhythm, not just an isolated extra beat, needs a captured EKG to identify and typically needs ongoing management.
• Thyroid changes. An overactive thyroid can produce a persistently fast or irregular heartbeat.
• Anemia. Lower oxygen-carrying capacity in the blood can make the heart pump harder and faster than usual.
• Medication effects. Some prescription and over-the-counter medications list palpitations as a known effect.

Why timing the capture matters

None of the causes above can be told apart from the feeling alone. An EKG taken while you're still symptomatic is the difference between a rhythm strip that shows exactly what was happening and a normal resting EKG taken after the moment has already passed, which is what usually happens when the episode isn't captured live.

What this means for you

If palpitations are a new or recurring thing for you, the most useful next step is usually the same one your doctor would suggest: capture what's actually happening in your heart's rhythm during an episode, and bring that, along with what you were doing, feeling, and any other symptoms, to your appointment.

That's the specific gap Palpi fills. It doesn't diagnose or interpret what an EKG shows. It times the episode, walks you through capturing an EKG on whatever device you have, and organizes what you noticed while it's still fresh, so you have real data instead of a description from memory.