Palpitations: Causes

What causes palpitations?

There are many causes of palpitations, which range from mild to serious. Your health care provider will most likely perform diagnostic tests to determine the underlying cause of your palpitations.

Cardiovascular causes of palpitations

Palpitations may be caused by a cardiovascular disorder or disease including:

• Cardiac arrhythmias (such as atrial fibrillation, supraventricular tachycardia, ventricular tachycardia)
• Cardiomyopathy (weakened or abnormal heart muscle and function)
• Coronary artery disease
• Heart ischemia
• Heart valve disease
• Hypertension (high blood pressure)
• Mitral valve prolapse

Gastrointestinal causes of palpitations

Palpitations may be caused by gastrointestinal disorders including:

• Gallstones
• Gastroesophageal reflux disease (GERD)
• Indigestion
• Pancreatitis
• Peptic ulcers

Psychological causes of palpitations

Palpitations may be caused by cardiac arrhythmias, in which the heart beats irregularly or too fast. Types of cardiac arrhythmias causing palpitations include:

• Anxiety and anxiety disorders
• Memory of a traumatic event
• Panic attack or panic disorders
• Stress

Respiratory causes of palpitations

Palpitations may be caused by respiratory disorders including:

• Acute bronchitis
• Asthma
• Bronchiolitis
• Chronic obstructive pulmonary disease (COPD)
• Pneumonia
• Pneumothorax (collapsed lung)
• Pulmonary edema (buildup of fluid in the lungs)
• Pulmonary embolism

Substance causes of palpitations

Palpitations may be caused by a variety of medications and substances including:

• Alcohol
• Amphetamines
• Coffee or any product containing caffeine
• Cold medications containing decongestants, such as ephedrine and pseudoephedrine
• Diet drugs
• Medications used to treat asthma, heart problems, high blood pressure, or thyroid disease
• Nicotine   
• Stimulants
• Street drugs such as cocaine, ecstasy, LSD, marijuana and methamphetamine

Other causes of palpitations

Other causes of palpitations include:

• Anemia
• Exercise
• Fever
• Hypoglycemia (low blood sugar)
• Perimenopause
• Trauma

Serious or life-threatening causes of palpitations

In some cases, palpitations may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

• Angina
• Aortic dissection (bleeding into the wall of the body’s main artery, the aorta)
• Heart failure
• Myocardial infarction (heart attack)
• Pericarditis (inflammation of the sac surrounding the heart)   

Questions for diagnosing the cause of palpitations

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your palpitations including:

• How long have you been experiencing palpitations?
• Do you feel a regular or irregular pattern to your heartbeat?
• Do you feel that your heartbeat is stopping or skipping?
• Do the palpitations begin or end suddenly?
• When do the palpitations occur? Do they coincide with any specific activities?
• Do you have any other symptoms?
• What medications are you taking?

What are the potential complications of palpitations?

Because palpitations can be caused by serious diseases, failure to seek treatment can result in serious or life-threatening complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Cardiac arrest
• Coma
• Difficulty breathing
• Hypoxia (low levels of oxygen in the blood)
• Respiratory failure and respiratory arrest