Feel my own heartbeat

When to Evaluate Heart Palpitations

Featured Expert:

Palpitations are symptoms of everything from short or long-term stress to a variety of arrhythmias (irregular heartbeats). They may feel alarming, but do not always reflect a serious heart condition.  Joseph Marine, M.D., vice-director of the Division of Cardiology at Johns Hopkins, starts his evaluation by asking his patients what they hear.

What are palpitations?

Palpitations are characterized as a general or heightened awareness of your own heartbeat – whether it’s too fast, too slow, or otherwise irregular. You might feel like your heart is thumping, racing, or fluttering. And you could feel this sensation in your chest or your neck.

“I ask them to tap out what their heartbeat feels like. Then I get a sense of whether we’re dealing with isolated skipped beats or a more sustained arrhythmia,” says Marine. “Patients frequently will feel their skipped beats more at night, when they’re lying in bed and nothing is distracting them from it.”

Diagnosing palpitations

Palpitations can occur for a variety of reasons unrelated to heart disease. These include:

  • Overexertion
  • Stress
  • Caffeine, alcohol, tobacco, or diet pills
  • Overactive thyroid
  • Hormone changes associated with menstruation, pregnancy, or menopause
  • Low blood pressure
  • Heart disease or abnormal heart valves
  • The body’s response to medications such as thyroid pills, cold medicines, and asthma drugs

Palpitations can also result from a range of heart arrhythmias. These are classified by location, and type of heartbeat. A few common types:

  • Supraventricular tachycardia – A rapid heart rate originating above the ventricles (lower heart chambers). It can cause the heart to beat very quickly or erratically. Symptoms might include an overly fast pulse and dizziness.
  • Atrial fibrillation – The most common type of arrhythmia, an atrial fibrillation can result in a rapid and erratic heartbeat, which may interfere with blood flow to the ventricles and possibly lead to serious clotting conditions or stroke. Symptoms might not exist at all, or involve chest pain, palpitations, or shortness of breath.
  • Ventricular tachycardia – A rapid heartbeat originating in the ventricles (lower heart chambers). When associated with structural heart disease, this arrhythmia may cause loss of consciousness and, in some cases, cardiac arrest or sudden death.

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Separating serious palpitations from harmless ones

It’s important to differentiate palpitations caused by stress or minor arrhythmias from those that may point to an underlying heart disease. Inconveniently, palpitations don’t always occur during the time you’re with your doctor.

Marine recommends coordinating an electrocardiogram (ECG) with the irregular heart beat symptoms the patient is having by using a Holter or event monitor.

A Holter monitor is a portable machine you would carry in your pocket or small pouch around your neck or waist for 24 to 48 hours. Electrodes connect your chest to the monitor wires to record your heart rhythms.

An event monitor records heart rhythms for a longer span of time (about a month). The patient activates the monitor whenever he or she experiences an irregular heartbeat.

Treating palpitations

Depending on the severity of the symptoms and underlying cause of the palpitation, your doctor will typically recommend one of three treatment options:

  • Preventive care (for non-severe palpitations) – Try eliminating smoking, excess caffeine, and alcohol from your daily regimen; practice general deep breathing and yoga; get plenty of sleep and exercise; regularly schedule “you” time.
  • Medications – Your physician might prescribe antiarrhythmic drugs such as beta blockers and calcium channel blockers, both of which have a safe track record. Occasionally these drugs don’t work effectively and stronger antiarrhythmic drugs that directly act on the sodium and potassium channels of the heart might be necessary.
  • Catheter ablation – Small wires are threaded through the leg veins into the heart to trigger an arrhythmia, identify the cause, and cauterize the problem area. This treatment is highly effective when the physician can identify an arrhythmia in a specific region of the heart (such as supraventricular tachycardia).

Other outpatient procedures include cardioversion (electric shock sent to the chest wall to synchronize the heartbeat to a normal rhythm), and an implantable defibrillator (a special type of pacemaker that automatically detects and terminates ventricular arrhythmias associated with heart disease).

Sometimes comfort and reassurance are the best medicine

“While palpitations can sometimes signal a more serious condition, they’re often just a sensation of a normal heartbeat,” says Marine. “Confirming that nothing is seriously wrong is sometimes all a person needs. Relaxation techniques and reassurance from a physician – I find that both are very helpful when the cause of palpitations is benign.”

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Causes, symptoms, treatment, and prevention

A bounding pulse is when a person feels their heart beating harder or more vigorously than usual.

People are often worried that a bounding pulse is a sign of a heart problem. However, anxiety or panic attacks cause many cases and will resolve on their own.

People may notice their heartbeat feels stronger in their chest or when they feel for their pulse in the neck or wrist. They might also notice an irregular heartbeat or heart palpitations.

In this article, we look at the causes and symptoms of a bounding pulse. We also discuss ways that people can treat or prevent it from happening.

A person experiencing anxiety will often feel their heartbeat increase.

A range of medical conditions can cause a bounding pulse. If the symptoms do not go away on their own, people should see a doctor to find out what is causing the symptoms.

Some of the most common conditions linked to pulse rate changes include the following:

Anxiety or panic attacks

Anxiety can cause the heart to beat more strongly and more rapidly. Anxiety is a temporary state, and a person’s heartbeat will return to normal when their fear or worry go away.

In cases of extreme anxiety, people might experience a panic attack. Panic attacks usually come on quickly and reach their peak within minutes. In some cases, they can feel like a heart attack, which can add more anxiety.

According to the Anxiety and Depression Association of America (ADAA), the symptoms of a panic attack include:

  • heart palpitations, or an irregular heartbeat
  • a pounding heart
  • a rapid heartbeat
  • chest pain or discomfort
  • shortness of breath
  • fear of losing control or dying

Panic attacks are not a sign of any underlying medical condition. Nevertheless, if a person experiences severe anxiety or panic attacks, they should speak to their doctor.


Dehydration can disrupt the balance of electrolytes in the body. A person’s heart may beat more rapidly to try and correct these imbalances.

A bounding pulse linked to dehydration is more common in people doing intense exercise, experiencing heat-related exhaustion, and those with metabolic disorders that affect their ability to absorb electrolytes.


People may feel their heart beating more quickly or vigorously when they have a fever.

A person’s body heats up when it is trying to fight off an infection, which means the heart has to work harder. This also occurs when people exercise or spend too much time in hot climates.

Some people also become more sensitive to changes in their heart rate when they are sick or have a fever, so they are more likely to notice changes in their heartbeats.


Some drugs and medications can cause the heart to beat faster. Some that may cause this effect include:

  • caffeine and nicotine
  • prescription medications, including Ritalin and other ADHD treatments
  • illicit substances, including cocaine

Hormonal imbalance

Hormones are the body’s chemical messengers. Changes in hormone levels can change the heart rate.

Thyroid diseases, such as hyperthyroidism, which causes the body to produce too much thyroid hormone, are a common cause of hormone imbalances.

People who experience a pounding heart and other symptoms, such as exhaustion or unexplained weight gain or loss, may have a thyroid condition.

Allergic reactions

Mild allergic reactions should not cause changes in people’s heartbeats. However, a severe allergic reaction, such as anaphylactic shock, can produce a rapid, bounding pulse.

Anaphylaxis usually happens within a few minutes of exposure to an allergen.

People experiencing anaphylaxis may have:

  • rapid, pounding heartbeat
  • trouble breathing
  • swollen throat or tongue

Electrical faults in the heart

The heart uses electrical signals to know when to pump and when to relax.

A problem with the heart’s electrical system can cause any of the organ’s four chambers to beat at an irregular rate, or to pump too fast and too hard. This can create the sensation of a bounding pulse.

One of the most common symptoms of an electrical problem is called paroxysmal supraventricular tachycardia (SVT). It often happens during exercise or stress and does not usually mean a person has a serious health problem.

Heart disease

A racing, bounding heart rate may be a sign of heart disease.

Heart disease is more likely in people with cardiovascular risk factors, such as:

  • smoking cigarettes
  • a family history of heart disease
  • being overweight

When the arteries are clogged, the heart has to beat harder to pump blood through the body. This damages the heart and may cause chest pain. It can also cause some people to experience a faster heart rate.

Problems with the heart valves

Aortic insufficiency, sometimes called aortic regurgitation, is where the heart valves do not close properly. This means that the heart cannot pump the blood as well as it should.

Heart disease and some other health problems, such as a bacterial infection, can weaken the heart and cause problems with the heart valves.

Aortic insufficiency can cause:

  • a bounding pulse
  • chest pain
  • weakness
  • swelling
  • fatigue


Shock is a medical condition where the heart does not pump enough oxygen-rich blood around the body. This can happen when a person has one of the following:

  • too little blood in their body
  • a problem with their heart’s pumping mechanism
  • widened blood vessels

Shock can cause the heart to beat faster to compensate. People may go into shock following a severe injury, especially one that causes organ damage or heavy bleeding. A racing heart following an injury is always a medical emergency.

During an episode of bounding pulse, a person may experience the following:

  • sudden increase in pulse rate, such that the heart feels as if it is beating very fast
  • feeling like the heart is beating very hard
  • anxiety about the heart
  • heart palpitations or an irregular heart rate

Some people also experience dizziness or light-headedness. These signs are often due to anxiety.

Anxiety can increase a person’s pulse and make the bounding feeling more intense. This change in pulse can make people feel even more anxious. Finding ways to manage anxiety, such as deep breathing or meditation, may help to break this cycle.

Seek medical help if chest pain is not linked to exercise and does not reduce with rest.

A bounding pulse does not necessarily mean a person has a medical condition, and it usually goes away on its own.

People who frequently experience a bounding pulse should consult a doctor, especially if the symptom is not due to anxiety.

If a person has other symptoms, it is vital to see a doctor quickly, as a bounding pulse associated with other signs may point to a further medical issue.

People should seek emergency medical help if a bounding pulse happens along with:

  • chest pain or pressure not associated with exercise and not improving after rest
  • intense jaw or shoulder pain, especially along with chest pain
  • confusion or changes in consciousness
  • a history of heart disease, stroke, or heart attack
  • starting new medication
  • exposure to a recent allergen, such as a bee sting
  • sweating profusely
  • heavy bleeding or a recent injury
  • spotting during pregnancy
  • a head injury

To find out the cause of a bounding pulse, a doctor will ask about a person’s symptoms and medical history.

The doctor may seek the following information:

  • when the changes in pulse rate began
  • whether a bounding pulse has happened before
  • what triggers the bounding pulse
  • other symptoms, such as an irregular heartbeat or ectopic beats
  • risk factors for heart issues, including family history of heart problems

A doctor may then order tests to measure the speed and regularity of a person’s heartbeat. An electrocardiogram (ECG or EKG) is one of the most common heart tests. It measures heart rhythms over time. Blood testing may also help rule out some causes, such as thyroid disease.

A person with a bounding pulse does not usually require treatment. However, people may need treatment for an underlying medical condition if that is causing their symptoms.

Treatment varies depending on the medical condition involved, but it may include medication, lifestyle changes, and ongoing medical monitoring.

A doctor may recommend regular stress tests to test how the heart responds to physical stress.

When anxiety causes changes in the pulse, people can try various ways to reduce their stress levels. These may include:

  • using deep breathing exercises when anxiety arises
  • learning ways to manage a panic attack
  • practicing meditation or mindfulness

Some people may also benefit from anti-anxiety medication and should speak to a doctor about the best options.

Regular exercise will help to keep the heart healthy.

The best ways to prevent a bounding pulse depend on the cause.

When anxiety causes these symptoms, people can prevent pulse changes by avoiding triggers or developing stress-management techniques.

When chronic health conditions cause a bounding pulse, people should speak to their doctor about the best ways to control their symptoms.

A number of strategies can prevent heart health issues if people are concerned about these or they have a risk of cardiovascular disease.

According to the American Heart Association, people can keep their heart healthy by using the following tips:

  • maintaining a healthy body weight
  • eating a balanced, nutrient-rich diet
  • exercising regularly
  • managing chronic health conditions
  • keeping anxiety and stress under control
  • limiting foods linked to heart health issues, including sodium and red meat
  • eating heart-friendly foods, such as non-fried fish, whole grains, and fruits and vegetables

For most people, a bounding pulse is temporary and will resolve on its own. Anxiety is often the cause.

If a person frequently experiences a pounding heartbeat, they should speak with their doctor to find the causes and triggers.

Heart health issues are usually treatable, and treatment can be more effective when people catch the problems early. People should speak to a doctor about any heart rate changes that persist or cause worry.

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What patients need to know

This European Society of Cardiology (ESC) patient guide is a summary of the most current evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it is designed to help patients understand:

  • what are the main types of heart failure;
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The website heartfailurematters.org was created under the direction of the Association of Heart Failure Specialists of the European Society of Cardiology (ESC). ESC is a world leader in the discovery and dissemination of advanced methods of cardiovascular medicine. Our members and decision makers are medical professionals who volunteer their time and knowledge as cardiologists in Europe and beyond.

Why do I feel my heart beating? 🧡


Many of us have experienced heart palpitations at least once in our lives - when the heart beats so frantically and loudly that it seems that it is about to jump out of the chest. If you have experienced such a phenomenon, then you probably wondered if it is the norm. We talked with doctors on this topic - let's figure it out together.

Why do I sometimes feel my heart beat clearly?

Head of the Clinical Diagnostic Department, cardiologist, therapist at the NACFF clinic, Candidate of Medical Sciences

“People usually do not feel their heartbeats in their usual calm state, but in some situations this sensation may appear. For example, during or immediately after physical exertion, as well as during emotional stress and stressful situations when hormones like adrenaline are produced - all this makes the heart beat faster and stronger.

Fitness Trainer, Dietitian and Nutritionist

“Heartbeats can increase due to high body temperature or heat. Also, smokers often experience tachycardia. Another reason for the possible rapid work of the heart in healthy people is detraining. In this case, the heart rate can increase even with minimal physical exertion, whether it is brisk walking, a short run or climbing stairs. This is facilitated by a sedentary lifestyle, inactivity, working at a computer or remote work / study, which is very relevant in our time. As a rule, such patients do not have serious pathologies with the heart. And you can eliminate the cause of tachycardia by changing your lifestyle!

Why is my heart beating so fast?

Pavel Alexandrov: The heart can pound furiously under high load - and this is normal. Moreover, the load can be both physical and emotional. If this occurs without any external cause, a pronounced palpitation may be a sign of a heart disease, arrhythmia (cardiac arrhythmias). In this case, you should immediately consult a doctor.

When is palpitations normal, and when is it dangerous and a signal for alarm?

Pavel Alexandrov: In a situation where we are talking about the presence of some kind of stress factor, during physical activity, a fast heartbeat, as a rule, is a normal, physiological response of the body . Also, heart palpitations are considered normal at high temperatures caused by diseases such as SARS or influenza. There is no need to take any special measures to lower the heart rate, the usual methods of lowering the temperature will lead to a decrease in the heart rate.

In the absence of physical and emotional stress, a pronounced heartbeat (more than 100 beats at rest or an irregular heartbeat) is a sign of illness and a reason to see a doctor.

How can I check my heartbeat or pulse?

Christie Lessing: To measure your resting pulse, press your index and middle fingers on the inside of your wrist, just below your thumb. Having caught the pulse beat, count the beats for 1 minute or 30 seconds and multiply by 2. For the reliability of the results, first sit quietly for 10 minutes. Also, the pulse can be measured near the ear, under the knee, in the groin and inside the elbow.

How can I help myself in case of a sudden increase in heart rate?

Christy Lessing:

  1. Try to relax and get into a comfortable position.

    Learn more