When you’re anxious, heart palpitations can be a startling symptom. But a rapid, fluttery, or pounding heartbeat during moments of anxiety is actually more common than you might think.

If you’ve ever paid attention to the way that anxiety feels, you probably know that it isn’t just “all in your head”. From the way your breathing changes to the jittery feeling in your arms and legs, there are many different ways that anxiety can affect you physically.

In fact, anxiety can even affect your heart rate, leading to heart palpitations and other symptoms, according to the American Heart Association (AHA).

Ahead, we’ll share everything you should know about the connection between anxiety and your heart, including steps you can take to manage or treat anxiety-related heart palpitations.

Anxiety isn’t just an emotional response. It can actually cause a handful of symptoms that you feel in your body, too. One of the most common physical symptoms of anxiety is changes in your heart rate, including heart palpitations.

Heart palpitations are rapid or irregular heartbeats. While palpitations can feel different from person to person, your heart may feel like it’s:

  • skipping beats
  • rapidly fluttering
  • pounding heavily
  • thumping in your ears

According to the National Alliance on Mental Illness (NAMI), heart palpitations are one of the many symptoms anxiety can cause, especially in people living with anxiety disorders.

But how does anxiety actually affect the heart, and why does it cause people to experience palpitations?

When you experience anxiety as a response to a real or perceived threat, it causes your body to enter into “fight, flight, or freeze” mode.

Your body’s stress response prepares you to face or escape from something potentially dangerous. As your nervous system activates this response, a cascade of hormones and chemicals produces changes in your mind and body.

You might notice that your senses become more focused, your breathing becomes rapid, and your heart rate increases, sometimes up to 100 beats per minute or more.

Our fight or flight response is usually only a short-term response, but in people who have chronic anxiety, sometimes these symptoms can continue to appear. And some mental health conditions can also cause panic attacks, which are associated with a handful of heart-related symptoms, such as:

  • palpitations
  • a racing heart
  • chest pain

Other causes of heart palpitations

Outside of stress and anxiety, there are several other underlying causes of heart palpitations, including:

  • heart conditions
  • prescription medications
  • alcohol and caffeine
  • recreational substances
  • not getting enough sleep
  • vigorous exercise

Causes of heart palpitations can vary from person to person. For example, you might notice that you’re able to tolerate caffeine without experiencing any palpitations, but that alcohol and anxiety are both triggers for your palpitations.

Although heart palpitations aren’t usually dangerous, they can be concerning, especially if you’re having them frequently. If you’ve been experiencing heart palpitations more than usual, consider scheduling an appointment with your doctor.

Your doctor can perform a physical examination and, if necessary, schedule an electrocardiogram (ECG/EKG). An ECG is a test that measures your heart’s electrical signals, which allows your doctor to determine what type of palpitations you’re experiencing and whether further testing is necessary.

If your palpitations are because of anxiety, here are some of the treatment approaches that can help.


Therapy is an effective treatment approach for anxiety because helps teach you the skills to manage your anxiety long-term. Several types of therapy are effective for treating anxiety disorders, such as:

Usually, treatment approaches differ depending on the type of anxiety you’re dealing with. For example, CBT is effective at treating conditions like panic disorder, while exposure therapy is more effective for conditions like specific phobias.


Medication can be used alongside psychotherapy to help reduce the symptoms of anxiety. Like therapy, there are several different types of anxiety medications, including medications that can be used to treat both depression and anxiety.

Some of the common medication options for chronic anxiety include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants. For acute anxiety, like panic attacks, medications like beta blockers and antihistamines can also be helpful.


In addition to reducing your anxiety, making lifestyle changes can also help decrease how often you experience heart palpitations.

For example, if you frequently notice that caffeine increases your anxiety and your heart palpitations, you may want to consider reducing your caffeine intake.

Or if you notice that poor sleep is affecting your anxiety levels and increasing your palpitations, it can be helpful to focus on your sleep hygiene.

If you’re experiencing increased heart rate, palpitations, or chest tightness but you’re not sure if it’s anxiety or not, consider seeking a physical exam.

When anxiety starts to feel overwhelming and uncomfortable in the moment, here are a few steps you can take to help bring your anxiety back down:

  • Focus on your breathing: Deep breathing is one of the best ways to calm your mind and your body during anxious moments. By focusing on taking slow, deep breaths, you can help relax your body and slow down your heart rate.
  • Accept how you feel: We all feel anxious from time to time, and it’s normal for our bodies to react when we do. If you can learn to accept that anxiety itself isn’t dangerous, it may help the anxious moment pass more quickly.
  • Try grounding activities: Grounding is a mindfulness skill that aims to bring your awareness to the present moment by focusing on your senses. Shifting your focus this way can help calm down both your mind and body and avoid the anxiety spiral.

It can take some trial and error to find what works for you. But once you’ve learned which coping skills help to calm you down, you can use those skills the next time you feel anxious.

It’s common for anxiety to cause heart palpitations, especially in people living with anxiety disorders who experience frequent and persistent anxiety. But even with short-term anxiety, symptoms like a racing heart, skipped beats, or a pounding heartbeat are all a part of the body’s response to anxiety.

If you’ve noticed that you’re experiencing frequent heart palpitations, consider scheduling a visit with your doctor so that they can offer the right diagnosis and treatment for you. You’re not alone. Support is available to help you cope.