From the Guidelines
Palpitations can be caused by various non-cardiac conditions, including anxiety disorders, panic attacks, stress, stimulant use, hormonal fluctuations, thyroid disorders, electrolyte imbalances, anemia, fever, dehydration, and certain medications, as well as conditions like postural orthostatic tachycardia syndrome (POTS) and vasovagal reactions 1.
Non-Cardiac Causes of Palpitations
Some of the non-cardiac conditions that can cause palpitations include:
- Anxiety disorders, panic attacks, and stress, which can trigger the sympathetic nervous system to release adrenaline, increasing heart rate and force of contraction
- Stimulant use, such as caffeine, nicotine, alcohol, and medications like pseudoephedrine, which can directly stimulate the heart
- Hormonal fluctuations during menstruation, pregnancy, or menopause, which can cause palpitations
- Thyroid disorders, particularly hyperthyroidism, which can lead to palpitations
- Electrolyte imbalances, especially potassium, magnesium, and calcium, which can disrupt heart rhythm
- Anemia, fever, and dehydration, which can lead to palpitations
- Certain medications, including some antidepressants, antihistamines, and antibiotics, which list palpitations as side effects
- Vasovagal reactions, which occur when the vagus nerve is stimulated, can cause heart rhythm changes perceived as palpitations
- Postural orthostatic tachycardia syndrome (POTS), which can cause heart rate increases upon standing
Management of Palpitations
Management of palpitations typically involves addressing the underlying cause, reducing stimulant intake, practicing stress reduction techniques, and maintaining proper hydration and electrolyte balance 1. In some cases, medications such as beta blockers may be prescribed to help control symptoms, especially in patients with mitral valve prolapse (MVP) and palpitations associated with mild tachyarrhythmias or increased adrenergic symptoms 1. Additionally, lifestyle modifications such as regular exercise, a balanced diet, and adequate sleep can help alleviate symptoms of palpitations. It is essential to consult a healthcare professional for proper diagnosis and treatment of palpitations, as they can be a symptom of an underlying condition that requires medical attention.
From the Research
Non-Cardiac Conditions Causing Palpitations
- Hyperthyroidism: a condition where the thyroid gland produces excess thyroid hormones, can cause palpitations, as well as other symptoms such as anxiety, insomnia, and unintentional weight loss 2.
- Anxiety disorders: conditions characterized by excessive fear and anxiety, can cause physical symptoms such as palpitations, shortness of breath, and dizziness 3, 4.
- Thyroid disorders: both hyperthyroidism and hypothyroidism can have serious effects on the cardiovascular system, including palpitations, via mechanisms such as dyslipidemia, hypertension, and endothelial dysfunction 5, 6.
Specific Conditions and Their Associations with Palpitations
- Hyperthyroidism: can cause palpitations, atrial fibrillation, systolic hypertension, and heart failure 6.
- Anxiety disorders: can cause palpitations, as well as other physical symptoms such as shortness of breath and dizziness 3, 4.
- Thyroiditis: can cause thyrotoxicosis, which may lead to palpitations 2.