Heart Palpitations Anxiety Symptoms

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 19, 2021

eart Palpitations Anxiety Symptoms image

Heart palpitations, including skipped, missed, unevenly spaced heart beats; racing heart; and pounding heart are often signs of anxiety disorder, including generalized anxiety disorder, social anxiety disorder, panic disorder, and others.

This article explains the relationship between anxiety and heart palpitations.

Heart Palpitations Anxiety Symptoms description:

  • Your heart feels and/or sounds as though it is beating unusually hard or ‘pounding’ in your chest and/or throat.
  • Your heart feels like it is racing or beating fast.
  • It feels like your heart is skipping beats, or has “flutters,” or feels like it stops, flops, or thumps in your chest. When it feels like your heart skips a beat, stops, flops, or thumps, it also can produce a tickle-like feeling in your chest or throat that makes you cough.
  • It feels like your heart beats are irregular or unevenly spaced.
  • It feels like your heart is fluttering instead of beating evenly and normally.
  • It feels like your heart is throbbing or pounding hard in your chest.

If you take your pulse, you may notice that your heartbeats are normal, faster than normal, or unevenly spaced.

When these hearth palpitation symptoms occur, many fear there may be a problem with the heart. Many also fear that they might be on the verge of a heart attack or that their heart could burst or suddenly stop beating.

Heart palpitations anxiety symptoms can occur whether the heart's rhythm is normal or abnormal.

Heart palpitations anxiety symptoms can be felt in your chest, throat, head, ears, or neck, and can be experienced as, or in association with, “pulsing,” “throbbing,” or “thumping” sensations anywhere in the body, internally and/or externally.

You also may become abnormally aware of your heart’s beating and action.

Heart palpitations anxiety symptoms may occur when physically active or when resting.

Heart palpitations anxiety symptoms can come and go rarely, occur frequently, or persist indefinitely. For example, you might feel these types of heart symptoms once in a while and not that often, feel them off and on, or feel them persistently.

These heart related symptoms can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

Anxiety caused heart palpitations can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur "out of the blue" and for no apparent reason.

These symptoms can range in intensity from slight, to moderate, to severe. They can also come in waves, where their strong one moment and ease off the next.

Heart palpitations anxiety symptoms can change from day to day and from moment to moment.

All of the above combinations and variations are common.

Anxiety heart palpitations can seem more disconcerting when undistracted, resting, doing deep relaxation, or when trying to go to sleep or when waking up from sleep.

NOTE: 'Skipped' heartbeats are actually not skipped, but unevenly spaced heartbeats. This symptom is often referred to as a PVC (Premature Ventricular Contraction) or PVCs.

To see if anxiety might be playing a role in your heart palpitations, you can rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test. The higher the rating, the more likely it could be contributing to heart-related anxiety symptoms.

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What causes anxiety heart palpitations?

Medical Advisory

While heart palpitations may seem like a cause for concern, most are harmless.

There are many causes of heart palpitations, including:

  • A lack of sleep/sleep disruption
  • An electrolyte abnormality - for example, low potassium
  • Anxiety, anxiety disorder
  • Being out of shape
  • Consuming alcohol
  • Dehydration
  • Dietary supplements such as ephedra, ginseng, bitter orange, valerian, or hawthorn
  • Exercise
  • Fever
  • Hormone fluctuations (due to menstruation, pregnancy, and menopause)
  • Hyperventilation
  • Ingesting stimulants (caffeine, chocolate, diet pills, energy boosters)
  • Lower than normal blood sugar (from not eating regularly)
  • Low levels of oxygen in the blood
  • Smoking (nicotine)
  • Standing up
  • Some prescription and over-the-counter medications (including some cold medications that contain pseudoephedrine, asthma drugs, beta-blockers, and anti-arrhythmics, to name a few)
  • Some recreational drugs (such as cocaine)
  • Stress

In rare cases, heart palpitations can be caused by an underlying medical condition. This is why we recommend you discuss this symptom with your doctor to rule out all other possible causes.

As listed, stress is a common cause of heart-related symptoms, including the stress caused by overly apprehensive behavior. Many people experience this symptom when their stress is elevated. While annoying and uncomfortable, these types of symptoms aren’t harmful. They are, however, an indication that your body is stressed.

As it pertains to stress, behaving anxiously activates the stress response, which immediately causes specific physiological, psychological, and emotional changes in the body that enhance the body's ability to deal with a threat—to either fight with or flee from it—which is the reason this response is often referred to as the fight or flight response.[1][2]

Part of the stress response changes include stimulating the heart rate in order to circular blood throughout the body so that it is better equipped to deal with a threat. This stimulating effect can cause heart palpitations.

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently, however, the body has a more difficult time recovering. This can cause the body to remain in a state of semi emergency response readiness, which we call stress-response hyperstimulation since stress hormones are stimulants.[3][4]

Hyperstimulation can cause the body to exhibit similar sensations and symptoms to that of an active stress response even though a stress response hasn’t been activated.[5]

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How to stop heart palpitations due to anxiety?

When heart palpitations are caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, heart palpitations should subside and you should return to your normal self. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

When heart palpitations are caused by hyperstimulation, it may take a lot more time for the body to recover and to the point where this symptom is eliminated.

Nevertheless, when the body has recovered from hyperstimulation, heart palpitations subside. Therefore, anxiety- and stress-caused heart palpitations needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about anxiety- and stress-caused heart palpitations. Sure, they can be unsettling and even bothersome. But again, when your body has recovered from the stress response or hyperstimulation, anxiety- and stress-caused heart palpitations subside.

If you are having difficulty with anxiety, its symptoms, and troublesome worry, you might want to connect with one of our recommended anxiety disorder therapists. Working with an experienced anxiety disorder therapist is the most effective way to overcome problematic anxiety.

All of our recommended therapists have experienced anxiety disorder, have successfully overcome it, and are medication-free. Their years of personal and professional experience make them an excellent choice to work with on your road to recovery.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including anxiety symptom heart palpitations.


1. Berczi, Istvan. “Walter Cannon's ‘Fight or Flight Response’ - ‘Acute Stress Response.’” Walter Cannon's "Fight or Flight Response" - "Acute Stress Response", 2017.

2. Selye, H. (1956). The stress of life. New York, NY, US: McGraw-Hill.

3. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

5. Yeun, Eunice, et al. "Repeated Stress Causes Cognitive Impairment by Suppressing Glutamate Receptor Expression and Function in Prefrontal Cortex." Neuron, 8 Mar. 2011.