What causes heart palpitations?
Older adults are more likely to have medical conditions that can increase their likelihood of having palpitations. But heart palpitations can show up in people of any age.
Some of the heart conditions that can cause heart palpitations include:
- Cardiac arrhythmia (an irregular heartbeat), including atrial fibrillation (also known as A-fib) and atrial flutter
- Supraventricular tachycardia (SVT)
- Premature atrial complexes (PACs)
- Premature ventricular complexes (PVCs)
- Tachycardia
Other issues that can cause heart palpitations include:
- Being dehydrated
- Caffeine, nicotine or alcohol
- Certain medications, including decongestants or inhalers for asthma
- Hormonal fluctuations in women who are menstruating, pregnant or about to enter menopause
- Problems with electrolytes, including low potassium levels
- Strong feelings of anxiety, fear or stress, including panic attacks
Overactive thyroid, also known as hyperthyroidism, can throw off the heart’s normal rhythm, causing palpitations. This type of thyroid disorder is treatable with medications to slow the heart rate and treat the overactive thyroid.
Heart palpitations and anxiety
Heart palpitations sometimes can be caused by extreme anxiety, rather than a heart condition. That might lead to a patient needing treatment for a possible anxiety disorder from a psychiatrist.
But we still have to make sure patients are checked out by a cardiologist for any possible heart problems first. We do have some patients who have been diagnosed before with anxiety and know that’s what’s happening. For the majority of patients, however, we don’t want to label their condition as an anxiety attack before knowing for sure that there isn’t a heart problem we need to address.
When to get help for heart palpitations
Most people’s hearts beat between 60 and 100 times per minute. If you’re sitting down and feeling calm, your heart shouldn’t beat more than about 100 times per minute. A heartbeat that’s faster than this, also called tachycardia, is a reason to come to the emergency department and get checked out. We often see patients whose hearts are beating 160 beats per minute or more. The body can’t sustain that for long periods of time.
You also should get checked out if you feel like your heart’s beating irregularly. The heart should beat steadily, like a metronome. If you feel like it’s pausing or skipping beats, that could be a sign of an abnormal heartbeat, which can increase the risk of a stroke.
