Is it normal to feel a skipped heartbeat?

Occasional skipped-beat sensations are common. They may actually represent an early heartbeat followed by a pause and stronger subsequent beat. Frequent, new, or symptomatic episodes should be discussed with a healthcare professional.

Can anxiety cause heart palpitations?

Yes. Stress and anxiety can activate the sympathetic nervous system and increase heart rate and awareness of heartbeat. However, not every palpitation should automatically be attributed to anxiety, particularly when other warning symptoms are present.

Can caffeine cause palpitations?

Caffeine can trigger palpitations in some people, especially at higher doses or in people who are particularly sensitive to stimulants. Individual responses vary.

Can dehydration cause a racing heart?

Dehydration can contribute to an increased heart rate because the cardiovascular system may need to work harder when circulating blood volume is reduced.

Should I stop exercising if I experience palpitations?

It depends on the circumstances. Palpitations that occur during exercise, especially when accompanied by chest pain, dizziness, fainting, or unusual shortness of breath, should be medically evaluated. Do not ignore significant symptoms simply because exercise is generally healthy.

Why do I feel palpitations when lying down?

Being still and lying quietly can make your heartbeat easier to notice. Some people also become more aware of premature beats at night. Frequent or symptomatic nighttime palpitations should be discussed with a healthcare professional.

What test detects heart rhythm problems?

An ECG can detect many rhythm abnormalities, but because palpitations can be intermittent, longer-term monitoring such as a Holter or patch monitor may sometimes be necessary.

Heart Palpitations: When They’re Harmless and When to Worry

Heart-Risk

Written by HeartView Health Editorial Team

Technology reviewed by Dishant Chanchad, Chief Technology Officer

Published August 13, 2026Updated September 4, 202612 min read

A heart palpitation that sudden awareness of your own heartbeat, whether it feels like a flutter, a skipped beat, or a hard pounding

A heart palpitation is the sudden awareness of your own heartbeat. It may feel like a flutter, a skipped beat, a flip-flop sensation, or a strong pounding in your chest.

Because the heart is closely associated with survival, feeling something unusual in your heartbeat can be frightening. Many people immediately wonder whether they are having a heart attack or developing a serious heart problem.

The good news is that many palpitations are harmless, particularly when they are brief, occasional, and occur without other concerning symptoms.

However, palpitations can sometimes be caused by an abnormal heart rhythm or another medical condition. Understanding what palpitations feel like, what commonly triggers them, and which warning signs deserve medical attention can help you respond appropriately rather than automatically assuming the worst.

What Exactly Is a Heart Palpitation?

A palpitation is not necessarily a disease or a specific heart rhythm.

It is a sensation of being unusually aware of your heartbeat.

Normally, your heart beats continuously without you consciously noticing every beat. Sometimes, however, the heartbeat becomes more noticeable because the heart is beating faster, stronger, earlier than expected, or irregularly.

People may describe palpitations as:

Fluttering in the chest
A feeling that the heart is “flip-flopping”
A skipped heartbeat
A pause followed by a stronger beat
A pounding heartbeat
A racing sensation
A heartbeat felt in the throat or neck
A sensation of the heart beating unusually hard while lying down

Palpitations can occur while sitting quietly, lying in bed, exercising, after eating, during stressful situations, or after consuming caffeine or alcohol.

They may last only a few seconds or continue for several minutes or longer.

Why Can a Skipped Beat Feel So Strong?

One of the most confusing experiences is feeling as though your heart has stopped for a moment.

In many cases, what feels like a “skipped beat” is actually an early heartbeat, followed by a slightly longer pause and then a stronger normal beat.

These early beats can originate in the upper chambers of the heart and are called premature atrial contractions (PACs). Similar early beats originating in the lower chambers are called premature ventricular contractions (PVCs).

PACs and PVCs are common.

In people without significant underlying heart disease, occasional premature beats are often not dangerous. However, the sensation can be surprisingly dramatic.

That is why the intensity of the sensation does not necessarily tell you how serious the underlying cause is.

Common Causes of Heart Palpitations

Palpitations can have many possible triggers. Some are temporary and relatively harmless, while others may require medical evaluation.

1. Caffeine

Caffeine is a common trigger for palpitations.

Coffee, tea, energy drinks, pre-workout products, cola, and some medications can contain caffeine or other stimulants.

Some people can drink several cups of coffee without noticing any change in their heartbeat, while others may experience palpitations after a relatively small amount.

If you repeatedly notice palpitations after caffeine, reducing your intake or changing the timing may help identify whether there is a connection.

2. Stress and Anxiety

Emotional stress activates the body's sympathetic nervous system.

Stress hormones such as adrenaline can increase heart rate and make each heartbeat feel stronger or more noticeable.

This can create a cycle:

Stress → increased adrenaline → stronger/faster heartbeat → awareness of heartbeat → more worry → increased adrenaline.

The sensation can therefore feel very real even when the heart itself is structurally healthy.

Breathing exercises, relaxation techniques, physical activity, adequate sleep, and addressing the underlying source of chronic stress may help reduce episodes for some people.

3. Dehydration

Dehydration can reduce circulating blood volume.

As a result, the cardiovascular system may need to work harder to maintain adequate circulation. Some people notice a faster or more noticeable heartbeat when they have not consumed enough fluids.

Dehydration may be more likely during hot weather, after heavy exercise, during illness, or after significant sweating.

4. Alcohol

Alcohol can trigger palpitations in some people.

The effect varies considerably between individuals and may occur during drinking or several hours afterward.

Alcohol can also interfere with sleep and contribute indirectly to palpitations through dehydration and changes in the nervous system.

If you repeatedly experience palpitations after drinking, keeping track of the pattern can be useful.

5. Lack of Sleep

Poor sleep can increase sympathetic nervous system activity and affect stress hormones.

After a night of insufficient or disrupted sleep, some people notice:

Faster resting heart rate
Stronger heartbeat
Increased awareness of heartbeat
More anxiety
Reduced exercise tolerance

Improving sleep quality and maintaining a consistent sleep schedule may reduce symptoms when sleep deprivation is a contributing factor.

6. Hormonal Changes

Hormonal fluctuations can affect heart rate and how strongly a person perceives their heartbeat.

Some people experience palpitations during:

Menstruation
Pregnancy
Perimenopause
Menopause

Hormonal changes are not the only possible explanation, however. New, persistent, or severe palpitations should still be discussed with a healthcare professional when appropriate.

7. Medications and Stimulants

Certain medications and substances can increase heart rate or trigger palpitations.

Possible examples include some:

Decongestants
Asthma medications
Stimulant medications
Thyroid medications
Weight-loss products
Supplements containing stimulants

Do not stop a prescribed medication on your own because you suspect it is causing palpitations. Instead, discuss the symptom with the prescribing clinician.

Medical Conditions That Can Cause Palpitations

Not all palpitations are caused by lifestyle triggers.

Medical conditions that may contribute include:

Anemia
Thyroid disorders
Electrolyte abnormalities
Low blood sugar
Fever or infection
Heart rhythm disorders
Structural heart disease
Certain valve conditions

This is one reason persistent or unexplained palpitations should not simply be dismissed as anxiety or caffeine.

The underlying cause matters.

When Are Palpitations More Concerning?

Most occasional palpitations are not emergencies.

However, certain features make medical evaluation more important.

Seek medical attention if palpitations are:

New and persistent
Becoming increasingly frequent
Lasting for several minutes or longer
Occurring repeatedly without an obvious trigger
Associated with exercise
Occurring in someone with known heart disease
Associated with a personal history of fainting
Associated with a family history of sudden cardiac death or significant arrhythmia

The combination of palpitations with other symptoms is particularly important.

Palpitations With Chest Pain

Palpitations accompanied by chest pain, pressure, tightness, or significant discomfort should not be assumed to be harmless.

Chest discomfort can have many causes, including some that require urgent treatment.

If significant chest pain occurs together with palpitations, particularly if it is new, severe, persistent, or associated with other symptoms, seek urgent medical evaluation.

Palpitations With Shortness of Breath

Mild awareness of your heartbeat after exercise is different from palpitations accompanied by significant difficulty breathing.

Shortness of breath during a palpitation can indicate that the heart rhythm or another underlying condition is affecting circulation or the body's ability to meet oxygen demands.

Significant or sudden breathing difficulty warrants prompt medical attention.

Palpitations With Dizziness or Fainting

Dizziness, near-fainting, or fainting during a palpitation is an important warning sign.

Some abnormal heart rhythms can cause the heart to beat too quickly, too slowly, or inefficiently enough to temporarily reduce blood flow to the brain.

If you faint during an episode of palpitations, seek medical evaluation rather than simply monitoring the symptom at home.

What About Palpitations During Exercise?

Palpitations can occur during exercise because heart rate naturally increases.

Feeling your heart beating harder during a workout is not automatically abnormal.

However, new or consistently recurring palpitations during physical activity deserve medical attention, especially when accompanied by:

Chest pain
Unusual shortness of breath
Dizziness
Near-fainting
Fainting
Significant weakness

A healthcare professional can determine whether further testing is appropriate.

How Doctors Evaluate Heart Palpitations

If your palpitations are persistent, recurrent, or concerning, a healthcare professional may start by taking a detailed medical history and performing a physical examination.

The next step depends on your symptoms and risk factors.

Electrocardiogram (ECG)

An ECG records the electrical activity of your heart.

It can identify certain abnormal rhythms, conduction problems, and other electrical patterns.

The limitation is that a standard ECG only captures a short period of time.

If your palpitations happen randomly, they may not occur while you are in the clinic.

Holter Monitor

A Holter monitor is a portable device that continuously records heart rhythm during normal daily activities.

Traditional Holter monitoring may last 24–48 hours, while newer wearable patch monitors may record for longer periods.

These devices can be particularly useful when symptoms are intermittent.

Event or Extended Rhythm Monitoring

If palpitations occur only occasionally, a longer monitoring period may be more useful.

Depending on the situation, a healthcare professional may recommend an event monitor, patch monitor, or another form of ambulatory rhythm monitoring.

The objective is simple:

Capture the heart rhythm while the symptoms are happening.

Blood Tests

Blood tests may be used to look for conditions that can contribute to palpitations.

Depending on the situation, testing may include evaluation for:

Thyroid abnormalities
Anemia
Electrolyte disturbances
Blood glucose abnormalities

The exact tests depend on the person's symptoms and medical history.

Echocardiogram

An echocardiogram uses ultrasound to create images of the heart.

It can help evaluate heart structure and function when a structural heart problem is suspected.

Not everyone with palpitations needs an echocardiogram.

Why Keeping a Palpitation Log Can Help

If your palpitations occur intermittently, a simple symptom diary can provide useful information.

Record:

Time:
When did it happen?

Duration:
How long did it last?

Activity:
Were you sitting, walking, exercising, or lying down?

Symptoms:
Did you experience dizziness, chest discomfort, shortness of breath, or weakness?

Food and drinks:
Had you consumed caffeine, alcohol, or an energy drink?

Sleep:
Did you sleep poorly the previous night?

Stress:
Were you experiencing anxiety or emotional stress?

Heart rate:
If you have a reliable device, what was your heart rate during the episode?

Over time, patterns may become visible.

For example, someone may notice that palpitations repeatedly occur after poor sleep and several caffeinated drinks.

That information can help guide a medical evaluation.

Can You Prevent Heart Palpitations?

You cannot prevent every palpitation because some occur without an obvious trigger.

However, certain lifestyle habits may reduce episodes for some people.

Stay Hydrated

Drink fluids regularly and pay particular attention to hydration during hot weather, illness, and exercise.

Monitor Caffeine Intake

If caffeine appears to trigger symptoms, experiment with reducing the amount and observe whether episodes become less frequent.

Prioritize Sleep

Aim for a consistent sleep schedule and adequate sleep duration.

Poor sleep can influence the nervous system and make palpitations more noticeable.

Manage Stress

Regular physical activity, breathing exercises, mindfulness, relaxation techniques, and adequate recovery can help manage stress-related symptoms.

Limit Alcohol if It Triggers Symptoms

If you consistently notice palpitations after drinking alcohol, reducing or avoiding alcohol may help.

Avoid Unnecessary Stimulants

Be cautious with energy drinks, high-stimulant supplements, and over-the-counter products that can increase heart rate.

Palpitations at Night: Why Do They Feel Worse?

Many people notice palpitations while lying in bed.

This does not necessarily mean that something dangerous is happening.

At night:

There are fewer distractions.
The environment is quieter.
You may become more aware of physical sensations.
Changes in body position can alter how strongly you perceive your heartbeat.
Stress about the next day can increase awareness of bodily sensations.

As a result, a heartbeat that might go unnoticed during a busy day can feel extremely prominent at night.

However, frequent nighttime episodes should still be discussed with a healthcare professional, particularly if they are accompanied by breathing problems, chest discomfort, dizziness, or fainting.

When Should You Seek Emergency Care?

Do not wait for a routine appointment if palpitations occur with serious warning signs.

Seek urgent medical attention if palpitations are accompanied by:

Chest pain or significant pressure
Fainting or loss of consciousness
Severe shortness of breath
Severe dizziness or near-fainting
A sustained, very rapid heartbeat with significant symptoms
New neurological symptoms or severe weakness

If symptoms are severe or rapidly worsening, use your local emergency medical service rather than attempting to diagnose the cause yourself.
A Simple Checklist for Your Next Doctor Visit

If you are experiencing recurring palpitations, consider bringing the following information:

When the episodes started
How often they happen
How long they last
Whether they occur at rest or during exercise
Your estimated heart rate, if available
Any chest discomfort
Any dizziness or fainting
Any shortness of breath
Recent changes in caffeine or alcohol intake
Changes in medications or supplements
Recent sleep problems
Relevant personal or family heart history

This information can make it easier for your healthcare professional to determine what evaluation is appropriate.

The Bottom Line

An occasional flutter, pounding sensation, or skipped-beat feeling is common and is often caused by factors such as caffeine, stress, dehydration, poor sleep, alcohol, hormonal changes, or premature beats.

The sensation itself does not tell you whether a palpitation is dangerous.

What matters is the pattern, frequency, duration, circumstances, and accompanying symptoms.

Pay particular attention when palpitations are new, persistent, repeatedly triggered by exercise, or associated with chest pain, shortness of breath, dizziness, or fainting.

Most importantly, do not panic over an occasional isolated flutter—but do not ignore significant warning signs either.

Understanding your symptoms and knowing when to seek medical care is a much more useful approach than trying to diagnose every unusual heartbeat yourself.

Medical Disclaimer

This article is provided for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Heart palpitations can have many causes, and individual circumstances vary. If you experience new, persistent, or concerning palpitations, consult a qualified healthcare professional. If palpitations occur with chest pain, fainting, severe shortness of breath, or other severe symptoms, seek immediate medical attention.

Sources & References

Heart palpitations. MedlinePlus, U.S. National Library of Medicine.

This article is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Read our Medical Disclaimer.

Frequently Asked Questions

Many palpitations are harmless, particularly occasional premature beats in people without underlying heart disease. However, palpitations can sometimes indicate an abnormal heart rhythm or another medical condition, so persistent or concerning symptoms should be evaluated.

Common Questions About Heart-Risk

What do heart palpitations feel like?

Heart palpitations can feel like fluttering, pounding, racing, or a skipped heartbeat. Some people may also feel their heartbeat more strongly in their chest, throat, or neck.

What commonly causes heart palpitations?

Common triggers include caffeine, stress or anxiety, dehydration, alcohol, lack of sleep, hormonal changes, and premature heartbeats such as PACs or PVCs. In many otherwise healthy people, these causes are not dangerous.

When should I worry about heart palpitations?

Palpitations deserve medical attention when they are persistent, repeatedly occur during exercise, or happen with symptoms such as chest pain, shortness of breath, dizziness, or fainting. A known heart condition or family history of serious heart rhythm problems is also important to discuss with a healthcare provider.

What can I do when I experience occasional palpitations?

If the palpitations are brief and you feel otherwise well, note when they happen and what may have triggered them, such as caffeine, stress, alcohol, dehydration, or poor sleep. Keeping a simple record can help identify patterns to discuss with your healthcare provider.

What Is a Normal Resting Heart Rate, and Why Does It Matter?

HEART RISK

August 11, 2026

What Is a Normal Resting Heart Rate, and Why Does It Matter?

Your resting heart rate the number of times your heart beats per minute while you’re at rest is one of the simplest and most useful windows into your cardiovascular health.

Resting Heart Rate vs Heart Rate During Exercise: What’s the Difference?