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What Causes a Racing Heartbeat?

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Medically reviewed by
UCLA Health Cardiology Fellow
Last updated March 27, 2024

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A racing heartbeat is a natural response to stress, but if you get it often or it lingers, it may be a sign of a serious health problem like a heart arrhythmia.

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What is a racing heartbeat?

A racing heartbeat is when you have a very noticeable irregular or fast heart rate. It usually means your heart is beating faster than 100 beats per minute. It has also been described as a pounding heart or heart palpitations.

A racing heartbeat is sometimes nothing to worry about. It’s normal to experience a pounding heart—in a stressful situation, when drinking alcohol or caffeine or smoking, during exercise, or even when you’re watching a scary TV show or movie.

Typically, your heartbeat returns to its usual rate shortly. But if your heart races frequently or you have other symptoms like chest pain, it’s important to see your doctor to make sure you don’t have a potentially serious condition like a heart arrhythmia (irregular heartbeat).

Pro Tip

While this symptom is very common, it is worth doing some further investigation—even in young, healthy people—to rule out other causes. —Dr. Jay Patel

What it feels like

When your heart races, it can feel like a fluttering or a pounding sensation in the chest. It may last for just a few seconds or for minutes to hours. The longer it lasts, the more worrisome it is.  Common symptoms that can accompany a racing heart include:

  • Flushing
  • Feeling warm
  • Lightheadedness or dizziness
  • Shortness of breath
  • Nausea
  • Loss of consciousness (in extreme cases)

When to go to the hospital for a racing heart rate

Go to the ER if your heart has been pounding for hours or if you have a loss of consciousness, chest pain, or trouble breathing. These could be signs of a heart attack.

If your symptoms don’t last long or they happen occasionally, see your doctor to make sure your racing heartbeat isn’t a sign of an illness.

Pro Tip

When a patient comes to me with a report of a racing heartbeat, my mind immediately starts branching out the possible diagnoses based on chunk categories: heart-related, metabolic-related, drug-related, and mental health–related. —Dr. Patel


1. Premature heartbeats

Premature beats are a type of abnormal heart rhythm that causes extra heartbeats. Electrical signals in your heart tell it when to beat, and you can have these extra heartbeats when the signal arrives too early. The early signals may come from the upper chambers of the heart (the atria) or the lower chambers (the ventricles).

Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are very common and affect people of all ages. Sometimes people have strong PACs or PVCs or a burst of them in a short period of time, which makes the symptoms noticeable. PACs and PVCs cause a racing heartbeat sensation for only a few seconds.

Very common: PVCs are found in 69% of young, healthy patients and over 99% of elderly patients. Similarly, at least 1 PAC was found in 99% of patients ages 18–60 [Sources: Circulation; Circulation].

Other symptoms:

  • Skipped heartbeat followed by a pause
  • Pounding or very strong heartbeat
  • Pounding feeling in the neck
  • Lightheadedness
  • Improvement in symptoms with activity

Treatment and urgency: Premature heartbeats that you feel occasionally (less than 5% of the time) can be treated safely without medication if the symptoms aren’t interfering with your day-to-day activities. If your symptoms are frequent or affecting your life, your doctor may prescribe medication to make your heart beat in a normal rhythm. Go to the ER if you have loss of consciousness or feel out of breath from these premature beats.

2. Heart arrhythmia

Heart arrhythmia is basically an irregular heartbeat. There are different types of arrhythmias but the most common one is atrial fibrillation (Afib). It is caused by problems with the electrical signals that tell your heart when to beat.

Uncommon: Atrial fibrillation affects between 1–2% of the US population (3-6 million people.) They are more common with age [Source: Circulation Research].

Other symptoms:

Treatment and urgency: Because there are different kinds of arrhythmias, the treatment you need and how quickly you should get medical care varies. Treatments range from prescription medications such as blood thinners to minimally invasive procedures called ablations, which block abnormal electrical signals and return your heartbeats to normal. Go to the ER if your heart pounds for hours or if you have any shortness of breath, chest pain, or loss of consciousness.

3. Anxiety

Anxiety can cause your heart to race, which can often lead to other symptoms. Anxiety attacks are a more extreme form of anxiety, and can cause a racing heart, chest pain, and other symptoms.

Common: About 30% of people with a racing heartbeat have a diagnosed psychiatric condition, and about 15–25% of people with an anxiety disorder have heart palpitations [Source: The American Journal of Medicine].

Other symptoms:

Treatment and urgency: Anxiety is typically treated with psychotherapy, and sometimes anti-anxiety medications are needed.

It’s not uncommon to have a mental health disorder and a heart problem at the same time, so it’s important to see your doctor to make sure you don’t have a heart problem.

4. Substance use and medications

Many types of medications and substances can cause a racing heartbeat. Prescription and OTC medications such as decongestant nasal sprays, rescue inhalers, excess insulin (which leads to low blood sugar), and thyroid hormone replacement are some of the medications that can make your heart pound. Your heart can also race if you suddenly stop taking certain medications, like beta blockers.

Substances that cause a racing heartbeat include alcohol, nicotine, caffeine, and illicit drugs like cocaine and methamphetamines.

Uncommon: Medications and substances contribute to less than 10% of people diagnosed with a racing heartbeat [Source: The American Journal of Medicine].

Other symptoms:

  • Headaches
  • Irritability
  • Dizziness

Treatment and urgency: Stop taking any medication or substance that causes your heart to race. If it’s a prescription medicine that is causing these side effects, make an appointment with your doctor to get the dose adjusted or the medication changed.  Go to the ER if you have symptoms of a drug overdose, which can include nausea and vomiting, trouble breathing, and loss of consciousness.

Dr. Rx

The most important things a patient should tell their doctor is about any other medical problems they have and medications they take, including non-prescribed substances. —Dr. Patel


The treatments for a racing heartbeat vary depending on the cause.

  • To check for a heart-related cause, your doctor may recommend an electrocardiogram (ECG) and possibly longer monitoring of your heartbeat.
  • You may be checked for other potential causes like low blood sugar (hypoglycemia) or an overactive thyroid gland (hyperthyroidism). If you’re diagnosed with a condition like these, treating it with the right medication can help return your heartbeat to normal.


Why is my heart racing all of the sudden?

Heart racing that occurs suddenly and goes away very quickly (within 1–2 seconds) is usually caused by premature heartbeats. A pounding heart that starts suddenly and lasts for several seconds to minutes and then abruptly stops may be a sign of an arrhythmia. If your heartbeat starts racing gradually, it’s less likely to be caused by an issue with the heart.

Why can I feel my heart beating in my chest when I’m lying down?

Lying still and in a quiet environment helps you be more in tune with all of the inner workings of your body. You’re more aware of your heartbeat and other bodily sounds, like gurgling during digestion. The sound of your heartbeat is even stronger when you lie down on your chest because the heart moves closer to the front of the body.

Why does my heart pound when I’m watching a scary movie?

A scary movie, like a stressful event, can make you feel anxious. When you’re under stress, there is a surge of hormones in the body called epinephrine and norepinephrine. These are stress hormones that heighten the body’s senses to prepare for any imminent danger or threat. The surge in these hormones speeds up the heartbeat, which allows more blood flow to the body and prepares it to deal with a frightening situation.

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UCLA Health Cardiology Fellow
Dr. Patel is a cardiology fellow at the University of California, Los Angeles. He received his undergraduate degrees in Mathematics and Psychology at the University of Illinois at Chicago, where he was a student in the Guaranteed Pre-Professional Admissions Program. After graduating summa cum laude with 2 degrees in 3 years, he matriculated to medical school at the University of Illinois. He compl...
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