Can anxiety cause heart palpitations?
Yes, anxiety can cause heart palpitations, including a racing, pounding or fluttering heartbeat and beats that feel skipped. In alert mode, adrenaline makes your heart beat faster and harder to get you ready to run, while inward attention makes those beats easier to feel.
Try the practice nowWhat happens in your chest
Palpitations are suddenly noticing your own heartbeat. You might feel pounding, racing, fluttering, thudding, or a beat that feels skipped or flipped. You can feel them in your chest, throat or neck. Palpitations are very common and usually harmless.
In alert mode, adrenaline makes your heart beat faster and harder, getting you ready to run. During anxiety, a racing heart is usually your heart's normal rhythm, sped up.
You might also notice a skipped or extra beat. These are called ectopic beats, and they are common in healthy hearts. They often feel like a pause and then a thud, because the beat right after the pause is stronger.
Why it feels so alarming
Anxiety turns your attention inward, so you notice heartbeats you would normally never feel. The same sensations labeled anxiety can also be read as excitement or anticipation.
When you feel a heavy thud or a sudden flutter in your chest, noticing it raises the alarm in your body. That new alarm speeds your heart up again. Checking your pulse again and again, or waiting for the next skip, keeps your attention locked on your heart.
A fast heartbeat can feel scary when you are sitting still, even when your heart is healthy. If a doctor has checked your heart, a fast beat from anxiety does not harm it. A racing heart that switches on and off suddenly, like a light switch, can be a rhythm problem that is often mistaken for panic, so get that checked.
Why palpitations show up at rest
After weeks of anxiety, the body can stop switching between rest mode and alert mode and stay in alert mode. Because the body holds that state, palpitations can show up on days you do not feel anxious, including when you are resting.
Everyday habits can also play a part when your system is already on edge. Caffeine, energy drinks, alcohol, nicotine, a lack of sleep and stress all make extra beats more frequent.
This state is trainable with daily practice. About 80% of vagus nerve fibers carry signals from the body to the brain, so body-based practices give the brain new information to read. Your heart naturally speeds up a little as you breathe in and slows a little as you breathe out, and a longer exhale leans on that slowing.
Try Cadence Breathing
- Sit upright, or lie on your back if that is easier. Relax your jaw and close your eyes or keep a soft gaze.
- Breathe in lightly through the nose for a count of 3, hold gently for 3, then breathe out smoothly and slowly for 6, without straining.
- If you run short of air, use 2, 2 and 4 instead, or skip the hold.
- Continue for ten rounds.
When to check with a doctor
- You have never had your palpitations checked.
- They last a long time, keep coming back, or are getting worse.
- Your heartbeat feels irregular often or all the time, or stays very fast when you are resting.
- They start while you are exercising (stop, and get seen within a few days).
- You have ever fainted with palpitations (get seen within a few days).
- You have a heart condition, or someone in your family died suddenly before age 50 or has an inherited heart condition.
- They come with weight loss, feeling hot and shaky, or tiredness and pale skin.
- You are pregnant, or use cocaine, meth or other stimulants.
Practice with the Stateshift app
Common questions
Why do I get heart palpitations at night?
Palpitations are often more noticeable at night or when you are lying down because the room is quiet. When you lie down, especially on your left side, your heart sits close to your chest wall, which makes your heartbeat easier to feel.
How do I stop heart palpitations from anxiety?
Breathe out for longer than you breathe in, using a steady count such as Cadence Breathing. Then move your hands and attention away from checking your pulse and place your focus on a pleasant sensation in the room, because attention on pleasant sensation is the opposite of a panic spiral. If your heart keeps racing fast and does not slow down within 15 minutes, or palpitations come with chest pain, fainting or breathlessness, call 911.
How does a doctor check heart palpitations?
A doctor can check your heart rhythm with an ECG. If your palpitations come and go, a doctor can also give you a small monitor to wear for a day or more to catch those beats while you go about your day. If your watch can record an ECG, one recording during an episode helps your doctor.