Heart palpitations are usually harmless and go away on their own. But they could also be a sign that you’re living with anxiety.

If you’ve ever suddenly become aware of your heartbeat, you’re not alone. It’s a common complaint healthcare professionals hear from their patients.

The sensation of being aware of your heartbeat is called heart palpitations. It may feel like your heart is beating fast, fluttering, or skipping a beat.

While it can be worrying and unpleasant, heart palpitations can be harmless in some cases and eventually go away. But heart palpitations can also signify a more serious underlying heart condition.

According to the American Heart Association (AHA), your heart beats around 100,000 times a day, but you don’t notice it most of the time.

A 2016 study suggests this may be because your brain blocks out the sensation of your heart beating so that it can focus on other senses such as sight, sound, and touch.

But when your heart begins beating abnormally, your brain starts to pick up on that, and you eventually become aware of it. This uncomfortable awareness of your heartbeat is known as heart palpitations.

You may feel your pulse in your neck, throat, or chest with heart palpitations. It can feel like your heart is:

  • racing, pounding or beating fast
  • skipping or adding extra beats
  • fluttering
  • flip-flopping

Heart palpitations usually last a few seconds to minutes. But they can last longer in some cases.

It’s also possible to become aware of your heartbeat by simply paying close attention to it. But this doesn’t qualify as palpitations.

According to research from 2022, some of the most common causes of heart palpitations are:

  • stress
  • too much exercise
  • certain drugs (alcohol, nicotine, and caffeine) and medications
  • health conditions such as anemia and hyperthyroidism
  • excessive sweating due to loss of electrolytes

The cause of heart palpitations is unknown for about 30% of cases, according to research from 2017. Palpitations may also be due to an underlying heart condition such as an irregular heartbeat (arrhythmia) or a heart defect.

Anxiety can also lead to palpitations, especially if it’s marked by hypervigilance — a state of heightened alertness and sensitivity to your surroundings. It develops as a way for the body to protect itself from threats.

When you’re hypervigilant, you may constantly look for any possible danger in your environment. This could cause you to perceive threats that aren’t real or overreact to minor threats. An example may be jumping at a loud noise or sudden movement.

Hypervigilance affects people who may have:

Heart palpitations are one of many symptoms you may experience if you have anxiety. Other symptoms that may occur alongside palpitations include:

  • excessive sweating
  • stomach pain
  • headaches and dizziness
  • fatigue

Hypervigilant states can produce similar symptoms, including sweating, fast heart rate, and fatigue. These symptoms may worsen when you’re in a new or unfamiliar environment or around strange people. These types of situations can often trigger heart palpitations.

You may also experience emotional symptoms such as fear, panic attacks, and feeling tense.

While heart palpitations are harmless in most cases, consider reaching out to a healthcare or mental health professional if:

  • they occur suddenly with no identifiable trigger
  • you have heart disease or risk factors for heart disease
  • they won’t go away and keep getting worse
  • they last longer than a couple of minutes
  • you have a history of heart disease in your family

Emergency medical attention is required if you have heart palpitations in addition to:

  • chest pain
  • feeling faint
  • shortness of breath

Heart palpitations often go away on their own without treatment. But you can take steps to reduce the chance of experiencing them or to help manage them.

Mindfulness meditation

Mindfulness meditation is the act of observing your thoughts and the present moment as it unfolds without judging or reacting to them.

This type of meditation has been shown to lower levels of the adrenocorticotropic hormone (ACTH), a hormone involved in the stress response, according to a 2018 study.

Cut out stimulants

Try to cut out or reduce how much caffeine you’re consuming. Caffeine can raise cortisol levels, according to research from 2006. This can make you feel more anxious.

Nicotine also acts as a stimulant, so try to reduce or eliminate your intake.

Some medications may cause an irregular heartbeat. Consider talking with a healthcare or mental health professional about any medications you’re taking and their possible side effects.

Deep breathing

Deep breathing is the act of consciously taking slow, deep breaths — inhaling slowly through the nose and exhaling through the mouth.

A 2017 study suggests that breathing deep into your diaphragm may help reduce anxiety and cortisol levels. It can also help slow a racing or pounding heart.

Light exercise

A 2018 review suggests that exercise in general, from light exercise such as going for a walk to more intense exercise, may help reduce anxiety.

Exercising can also help take your mind off any irregular heartbeats.

Get good sleep

Lack of sleep can make you less able to handle stress and more likely to experience heart palpitations. You can get optimal sleep by following a consistent sleep schedule and avoiding electronic devices at night.

Get help

Controlling anxiety can be difficult by yourself. But talking with a close friend or family member about your anxiety may help.

If your anxiety is interfering with your daily life, consider reaching out to a mental health professional. They can help you manage your symptoms and recommend treatment if needed.

How common is it to have heart palpitations with anxiety?

Heart palpitations are a common physical symptom of anxiety.

In fact, it’s one of the diagnostic criteria for generalized anxiety disorder listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

Hypervigilance is also a common feature of anxiety disorders.

Who’s at risk?

You’re more likely to experience heart palpitations if you:

  • are older
  • have severe anxiety and panic attacks
  • are pregnant
  • have an overactive thyroid gland
  • have other heart problems

Heart palpitations occur when you become aware of your heart beating strangely.

While palpitations can sometimes indicate a medical problem, such as a heart issue or low blood count, they’re often harmless and may go away after some time.

Reducing your stress levels, deep breathing, getting enough sleep, and avoiding stimulants can help reduce the chance of getting palpitations and manage them when they happen.

If your palpitations are bothersome or unexplained, evaluation by a healthcare professional is recommended. If they’re accompanied by shortness of breath or chest pain, call 911.