Understanding Heart Palpitations & Anxiety: Common Causes

Palpitations (awareness of heartbeat) and anxiety often coexist. Common triggers:

• Stress/cortisol/adrenaline surge
• Caffeine, nicotine, stimulants
• Medications: Decongestants, bronchodilators, thyroid hormone, some antidepressants.
• Medical conditions: Hyperthyroidism, anemia, electrolyte imbalance, hypoglycemia, pheochromocytoma, cardiac arrhythmias.
• Dehydration
• Panic disorder/GAD/OCD/specific phobias
• Hormonal: PMS, perimenopause, pregnancy.

Evaluation: History, exam, ECG, basic labs (TSH, CBC, electrolytes, glucose), possibly Holter/event monitor, echocardiogram. Treatment targets cause: lifestyle modification, CBT, medication adjustment, antiarrhythmics, anxiolytics.

Seek urgent care for palpitations with chest pain, syncope, dyspnea, or known heart disease.