Understanding heart palpitations

Heart palpitations are irregularities in the heart’s rhythm. These irregularities can include a feeling that your heart is racing, skipping a beat, or flip-flopping in the chest.

Sometimes patients report a general sense of uneasiness, lightheadedness, or a loss of consciousness accompanying palpitations.

What causes a palpitation?

Palpitations occur for a variety of reasons, including what you have had to eat or drink.

Michael Giudici, M.D., a University of Iowa cardiologist who specializes in arrhythmias, lists these elements as reasons for occasional heart palpitations:

  • Caffeine-related palpitations can come from drinks like espresso that are high in caffeine. Reduce or eliminate beverages that contain caffeine such as coffee or soda to avoid palpitations.
  • Consuming large quantities of chocolate has been linked to heart palpitations. Chocolate provides the same stimulants as caffeine and can trigger abnormal heart rhythms.
  • An increase in alcohol consumption can cause heart palpitations, especially in patients with previous heart problems.
  • Some over-the-counter medications that contain decongestants, such as cold and allergy medications, act as stimulants increasing the risk of palpitations.
  • Fatigue, stress, and lack of sleep can either cause or worsen palpitations—managing stress and developing healthy sleep habits is important.

What if you experience frequent or severe palpitations?

Heart palpitations are among the most common heart related symptoms that people report. They are often harmless episodes that come and go, however, on occasion, they are a symptom of an underlying serious heart rhythm disorder.

Begin by consulting your primary care physician. Your doctor can review the food and beverages you consume along with over-the-counter medications you take and determine what may have caused the palpitation. Your doctor may recommend a thorough physical exam focusing on the heart and lungs.

Unless you experience a more severe symptom such as extreme lightheadedness, chest pain, shortness of breath, or loss of consciousness, occasional palpitations should not cause great concern in patients who are otherwise healthy and have no previous heart conditions.

If more serious symptoms occur, however, it would be smart to visit with a cardiologist.

What are the treatment options for palpitations?

For patients who have more serious heart rhythm disorders, an electrophysiologist will perform a number of diagnostic tests to determine the cause of the arrhythmia. Once the disorder is identified, the electrophysiologist has the option to try medications, lifestyle changes, procedures, and implanted devices to correct the problem.

A final note from Dr. Giudici

“The causes of palpitations are usually benign and do not require treatment, however they should not be ignored. If you notice an occasional palpitation and are otherwise healthy it’s unlikely anything serious is going on.”

Last reviewed: 
January 2016

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