What Causes Heart Palpitations (Arrhythmia)? Psychological or Cardiological?

In a significant proportion of the patients who come to us complaining of palpitations, the underlying cause is not the heart directly, contrary to what is assumed, but a different trigger. In this article I will explain the possible causes of palpitations.

What Is Tachycardia?

We call it tachycardia when the heart beats faster than normal; sometimes this is a genuine rhythm disorder (arrhythmia) arising from the heart’s own electrical system, and sometimes it is the result of an external trigger that simply speeds up a completely healthy heart. Distinguishing between the two is critically important for determining the right treatment.

The Effect of Stress, Caffeine and Anaemia on Palpitations

Intense stress, anxiety, excessive caffeine consumption, sleeplessness and anaemia are among the most common causes that can create a sensation of palpitations even though the heart is completely healthy. In these situations the heart speeds up not to protect itself but in response to the body’s increased need (for example, to compensate for the reduced oxygen-carrying capacity caused by anaemia).

When Is a Holter Monitor Needed?

If palpitations recur frequently, are accompanied by a feeling of fainting, or there is a history of known heart disease, we aim to capture the actual rhythm at the moment of palpitations by fitting a Holter device that records the heart rhythm for 24-48 hours or longer. This recording clarifies whether the palpitations are due to a genuine arrhythmia or to a harmless trigger.

Frequently Asked Questions

Do palpitations always mean heart disease? No; most of the time they are related to non-cardiac causes such as stress, caffeine or anaemia. However, palpitations that recur frequently or occur together with fainting must always be evaluated.

If I cut out caffeine, will my palpitations go away? In caffeine-related palpitations, yes, a reduction or complete resolution can be seen.

My EKG was normal but my palpitations continue, what should I do? A single EKG may not capture occasional palpitations; in this case we recommend Holter monitoring.

Conclusion

Heart palpitations are not always a sign of serious heart disease; non-cardiac causes such as stress, caffeine and anaemia are also common. Palpitations that recur frequently or occur together with fainting always require detailed evaluation.

You can book an appointment for a detailed evaluation to clarify the cause of your palpitations.

References

1. Barsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. Psychiatric Disorders in Medical Outpatients Complaining of Palpitations. J Gen Intern Med. 1994;9(6):306-313.