Heart Palpitations and Tight Throat: Causes from Anxiety to Thyroid

Palpitations with throat tightness (globus sensation) have diverse etiologies:

Psychogenic

• Anxiety/Panic: Sympathetic surge → tachycardia, throat muscle tension, hyperventilation.
• Stress: Similar mechanism.

Endocrine

• Hyperthyroidism: Tachycardia, palpitations, throat tightness (goiter), weight loss, tremor, heat intolerance.

Cardiac

• Arrhythmias: AFib, SVT, PVCs → palpitations; if reduced output → dyspnea, throat discomfort.
• Heart Failure: Dyspnea, orthopnea, fatigue.

Respiratory

• Asthma/Bronchitis/Laryngitis: Airway inflammation → throat tightness, dyspnea → compensatory tachycardia.

GI

• GERD: Acid reflux → throat burning, globus; vagal stimulation → palpitations.

Other

• Medication side effects (stimulants, decongestants, thyroxine excess).
• Dehydration → compensatory tachycardia.
• Smoking → nicotine tachycardia, airway irritation.
• Anaphylaxis: airway edema, hypotension, tachycardia — emergency.

When to Seek Immediate Care

Chest pain, syncope, severe dyspnea, wheezing, swelling of lips/tongue, palpitations with fainting. Otherwise, schedule evaluation for persistent symptoms.