What is the cause of palpitations in the setting of sleep deprivation and excessive caffeine use?

Anxiety or Stress-Related Palpitations: The symptoms of heart fluttering, lack of sleep, and caffeine use are commonly associated with anxiety or stress-related palpitations. Caffeine is a stimulant that can exacerbate heart palpitations, and lack of sleep can increase stress and anxiety levels.

Caffeine-Induced Arrhythmia: Caffeine can cause arrhythmias, including atrial fibrillation or supraventricular tachycardia, especially in high doses or in sensitive individuals.
Sleep Deprivation-Related Cardiac Effects: Chronic sleep deprivation can lead to cardiac effects, including palpitations, due to the disruption of normal physiological processes.
Dehydration: Inadequate fluid intake, possibly exacerbated by caffeine use, can lead to dehydration, which may cause heart palpitations.

Cardiac Arrhythmias (e.g., Atrial Fibrillation, Supraventricular Tachycardia): Although less likely, it is crucial to rule out underlying cardiac arrhythmias, as they can be life-threatening if left untreated.
Hyperthyroidism: An overactive thyroid gland can cause heart palpitations, and although less common, it is essential to consider this diagnosis to avoid missing a potentially treatable condition.
Cardiomyopathy or Myocarditis: In rare cases, heart palpitations can be a symptom of underlying cardiomyopathy or myocarditis, which can be life-threatening if not addressed promptly.

Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic palpitations, hypertension, and other symptoms.
Mitral Valve Prolapse: A condition where the mitral valve does not close properly, which can cause heart palpitations, although it is often asymptomatic.
Electrolyte Imbalances (e.g., Hypokalemia, Hypomagnesemia): Although rare, electrolyte imbalances can cause cardiac arrhythmias and palpitations, highlighting the importance of considering these diagnoses in the appropriate clinical context.