Desmond Kaplan MD FAPA

Child, Adolescent & Adult Psychiatry

1777 Reisterstown Road, Suite 50
 Baltimore, MD 21208


Patients who experience heart palpitations feel that their hearts are beating rapidly (tachycardia), fluttering, beating irregularly, or pounding. Normally, heart palpitations are not serious and are often triggered by stress, anxiety, exercise or certain medications. Heart palpitations may occur while the patient is sitting, standing, or lying down, during or immediately after strenuous activity, or during periods of rest. They are occasionally felt in the throat or neck, as well as in the chest.

Risk Factors for Palpitations

Individuals are at greater risk for palpitations if they fit into any of the following categories:

  • Are highly stressed or prone to anxiety
  • Are pregnant
  • Take medications containing stimulants
  • Have hyperthyroidism
  • Have heart problems
  • Consume excessive caffeine
  • Smoke or drink alcohol to excess
  • Use recreational drugs

Patients with fever, nausea or vomiting, anemia, hypoglycemia (low blood sugar), hyperthyroidism or lung disease are also susceptible to palpitations.

Complications of Palpitations

While occasional, fleeting palpitations do not normally require medical evaluation, palpitations that occur frequently, worsen, or are associated with other troubling symptoms, such as chest pain, severe shortness of breath, dizziness, or fainting, should not be ignored.

In rare instances, palpitations may be associated with one of the following:

  • Sudden drop in blood pressure
  • Fainting
  • Life-threatening arrhythmia
  • Cardiac arrest
  • Heart failure
  • Stroke

In such cases, diagnostic testing, such as heart or blood-pressure monitoring, is necessary.

Diagnosis of Palpitations

In order to diagnosis palpitations and their cause, one or more of the following tests may be administered:

  • Electrocardiogram (EKG or ECG)
  • Stress test
  • Holter monitor
  • Echocardiogram

If a heart condition is found to be the underlying cause of a patient's palpitations, lifestyle changes or medications may be prescribed or surgical intervention may be necessary. If serious causes of palpitations are ruled out, patients are typically advised to avoid triggers, such as excessive caffeine or alcohol, and medications with stimulating properties. If underlying non-cardiovascular conditions, such as hyperthyroidism or generalized anxiety disorder, are found to be causative, such issues must be medically addressed.

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