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Heart palpitations: anxiety or something else?

If you’ve ever felt fluttering in your chest or like your heart is pounding, you know it can be a little shocking or scary.  

“When your heart beats rapidly or irregularly for a few seconds, you might feel this odd sensation in your chest, neck or throat,” says Dr. Pugazhendhi Vijayaraman, cardiac electrophysiologist and director of cardiac electrophysiology at Geisinger Northeast.  

This fleeting feeling like your heart is fluttering is a called a heart palpitation, and most of the time it’s not cause for concern.  

Heart palpitations can be caused by anxiety, dehydration, a hard workout or if you’ve consumed caffeine, nicotine, alcohol, or even some cold and cough medications. Women who are pregnant also commonly experience heart palpitations.  

“If you experience heart palpitations that are linked with anxiety, you may feel other symptoms like an upset stomach or sweaty palms,” says Dr. Vijayaraman. You can likely attribute this anxiety to a life event like stress at work or home, or a job interview.  

But if heart palpitations last more than a few seconds at a time, increase in frequency over time, or if you know you have an existing heart condition, this fluttering may be something more than just anxiety. It might be atrial fibrillation, or AFib.  

“During atrial fibrillation, blood pools in the upper atria and the heart flutters, or fibrillates, as it tries harder to pump out this blood to other chambers of the heart and through the body,” explains Dr. Vijayaraman.   

Other symptoms of AFib include dizziness, shortness of breath, weakness or general fatigue and chest pain.  

For some people, AFib lasts a few days at a time and their heartbeat returns to normal. For others, AFib can last longer or become chronic. Whether the flutters are short-lived or become permanent, AFib increases the risk of stroke and heart failure.  

“Any time your blood isn’t pumping consistently through your body, you could be at risk for a stroke,” says Dr. Vijayaraman. “Patients with AFib are five times more likely to have a stroke than those without it.” 

It’s important to see a doctor if you notice that your heart palpitations are occurring regularly or increasing in frequency.  

“A doctor may monitor your heartbeat and conduct tests to determine if you have AFib,” said Dr. Vijayaraman. “Understanding your family health history and any current health issues can also help your doctor accurately diagnose your irregular heartbeat.” 

It’s also important to note that some people who have AFib don’t experience heart flutters or other symptoms at all.

“Occasionally, a patient will be diagnosed with AFib during a routine checkup,” notes Dr. Vijayaraman. “That’s why it’s so important to see your doctor regularly, especially as you age.” 

To make an appointment with Dr. Vijayaraman or another heart rhythm specialist at Geisinger, visit or call 800-275-6401.