How to Manage Palpitations

by Jerry Kennard, Ph.D. Medical Reviewer

One of the most common symptoms of anxiety is an acute awareness of one's own heartbeat. These heartbeats, or palpitations, may involve a sense of the heart beating rapidly, often accompanied by abnormal rhythms. Some people describe heart flutter as a sensation. There may be awareness of extra beats or missing beats. Palpitations may occur during activity or at rest. Little wonder that such pronounced sensations lead many to question whether they are about to have a heart attack. Very often this results in calls for medical assistance.

Palpitations themselves are not serious but they could indicate something more severe. Some estimates suggest that nearly 50 percent of referrals to cardiac specialists come from complaints of palpitations. Despite this, most cases tend to be due to anxiety.

Before anxiety is ruled in, the doctor will first want to exclude any physical causes, which can include diet and lifestyle. Fitness, especially if this involves vigorous forms of exercise, is one cause of palpitations. Most people however will not fall into this category and so the line of questioning is likely to be more down to earth. For example, you may be asked about your alcohol consumption, whether you smoke, whether you use high energy drinks (which often contain high levels of caffeine). You may also be asked whether you use any form of recreational drugs like cocaine or ecstasy or whether you are currently taking any form of medication. If you have recently stopped taking medication, especially if this was some form of sedative, you should mention this. Women may feel palpitations during pregnancy or menstruation and this tends to subside without any further intervention.

You may then have blood tests taken to check for thyroid function or other possible anomalies. It is possible that further investigations, such as an ECG, may be recommended.

A diagnosis of palpitations due to anxiety is invariably reached if all the physical tests draw a blank and there appears to be sufficient background evidence of anxiety or stress that has lead to strong emotions.

Very often, palpitations simply seem to go away, but if you are prone there are some things you can do to prevent or reduce their occurrence. In many ways these reflect the questions you may have been asked during a medical consultation - if indeed you had one. Some people however seem to make the association between stress and palpitations and look to changes in themselves. This is probably a wise cause of action as lifestyle changes can make a significant difference. If they don't, or you remain troubled by palpitations, then it's off to the doctor with a report of the action you have already taken to reduce your symptoms.

Self help involves identifying the things that can trigger palpitations and then taking action to avoid or modify them. If you smoke, you should aim to stop. This goes for alcohol, caffeine and any recreational drugs you may be taking. Cut out nutritional supplements and be aware of the fact that many cough medicines and tonics contain caffeine or other types of stimulant.

Look carefully at your diet and make adjustments so that you cut out processed, fatty and convenience foods, many of which have very high fat, sugar or salt content. If you are overweight, try to slim down by using a combination of a balanced diet and some regular daily exercise.

Relaxation is important but it doesn't have to be passive. You may of course benefit greatly from meditation or listening to a relaxation tape, but some people simply can't adjust to this. Alternatives exist in the form of activities like yoga or tai chi, but if you don't like the idea of a formal group then something along the lines of gardening or just a walk in the park are alternatives.

When palpitations appear a fairly common response is to resist the sensation and will it away. Dr. Jay Winner M.D., in a Psychology Today weblog, says this is entirely the wrong way to go about things. Heart rate increases the more anxious we become so Winner says the trick is to embrace what is happening. "Allow your heart to race as fast as it likes. Without judging or resisting your thoughts", he says, "instead of resisting the anxiety, enjoy the feeling of energy coursing through your veins." It's an interesting perspective and one that invites people to swap catastrophic thinking with something more positive. The job of the heart is to beat, that's all it does, so just let it happen. Combine these lifestyle changes and positive thinking with a regular sleep pattern and your experience of palpitations should either stop or be greatly improved - as will your general sense of wellbeing.


Dugdale, David C (2008, Jan). Medical Encyclopedia: Heart Palpitations. Retrieved July 14, 2009, from MedlinePlus Web site:

What Are Palpitations?. Retrieved July 12, 2009, from National Heart Lung and Blood Institute Web site:

Winner, Jay (2009, Jan). Palpitations: Anxiety or Heart Disease?. Retrieved July 14, 2009, from Psychology Today Web site: (2007).

Palpitations. Retrieved July 14, 2009, from Web site:

Jerry Kennard, Ph.D.
Meet Our Writer
Jerry Kennard, Ph.D.

Jerry Kennard, Ph.D., is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry’s work background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of