Why do i feel like my heart is pounding

Most people don’t notice their heartbeat. But some people may experience heart palpitations, which are sensations that feel like your heart is pounding or racing.

It’s possible to experience heart palpitations at any time of day. However, some people may notice them more often or exclusively at night. Here’s what to know about heart palpitations felt at night.

Heart palpitations at night involve feeling a strong pulse in your chest, neck, or head after you lie down to sleep. While these may seem unsettling, they’re usually not a sign of anything serious.

Heart palpitations when lying down at night

If you sleep on your side, you may be more susceptible to heart palpitations at night due to the way your body bends and pressure builds up internally.

Another factor to consider when experiencing palpitations at night is that they may be happening all day without you noticing. In this case, you might notice them at night due to lower noise levels and reduced distractions while you lie in bed.

The symptoms of heart palpitations can be concerning if they’re unexpected or you haven’t experienced them before. These symptoms include:

  • the feeling of an irregular pulse or that your heart stopped briefly
  • a sensation of “fluttering” in your chest
  • a fast or pounding heart rate

Short and infrequent palpitations at night are usually not a cause for alarm. Generally speaking, heart palpitations are usually harmless.

However, you should seek immediate medical attention if you experience heart palpitations along with any of the following symptoms:

  • shortness of breath
  • fainting or loss of consciousness
  • chest pain
  • feeling lightheaded

There are several factors that can cause heart palpitations, some of which you may come into contact with every day, including:

  • stimulants, such as caffeine, nicotine, over-the-counter medications containing pseudoephedrine, or drugs like cocaine or amphetamines
  • medical conditions, such as anemia, low blood pressure, low blood sugar, or thyroid disease
  • chocolate
  • alcohol
  • fatigue or lack of sleep
  • depression or anxiety
  • stress
  • fever
  • rigorous exercise
  • changes in hormones due to pregnancy, menopause, or menstruation

Unless you’ve already seen a doctor and determined that you have an underlying heart condition, heart palpitations generally don’t require any treatment. Symptoms tend to go away within a few seconds.

Avoiding triggers of palpitations is the most important way you can prevent them. For example, if you’re a heavy smoker or drinker, consider quitting or cutting back your tobacco or alcohol intake.

One method of identifying triggers is to keep track of the nights that you experience heart palpitations and ask these questions:

  • When did the episode occur?
  • How long did it last?
  • How were you feeling before and after?
  • Are you excessively worried about something?
  • Were you doing any activities when it happened?
  • Did you participate in any unusual behavior before bed, like consuming food you don’t usually eat?

Sharing this information with a doctor can also help them identify any underlying conditions that may require treatment.

If you’re experiencing frequent heart palpitations at night, consider scheduling an appointment with a doctor. They can conduct a review of your medical history. They might recommend a physical examination and tests, such as:

  • an electrocardiogram
  • blood work
  • an ultrasound of your heart
  • an exercise stress test if there’s accompanying chest pain
  • a Holter monitor to monitor your heart’s activity over a period of time if you might have an irregular heartbeat

If a doctor suspects you have an underlying condition, they may also need to conduct more invasive studies.

While heart palpitations at night can be concerning, they’re likely nothing serious.

If your symptoms worsen or persist for a long period of time, set up an appointment with a doctor. They can determine if you have a more serious condition or if your condition makes you more susceptible to heart enlargement.

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Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.

You may:

  • Have an unpleasant awareness of your own heartbeat
  • Feel like your heart skipped or stopped beats

The heart's rhythm may be normal or abnormal when you have palpitations.

Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise routinely or take medicines that slow the heart.

If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.

Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.

The following conditions make you more likely to have an abnormal heart rhythm:

  • Known heart disease at the time the palpitations begin
  • Significant risk factors for heart disease
  • An abnormal heart valve
  • An electrolyte abnormality in your blood -- for example, a low potassium level

Heart palpitations can be due to:

  • Anxiety, stress, panic attack, or fear
  • Caffeine intake
  • Cocaine, methamphetamine or other stimulant drugs
  • Decongestant medications, such as phenylephrine or pseudoephedrine
  • Diet pills
  • Exercise
  • Fever
  • Nicotine intake

However, some palpitations are due to an abnormal heart rhythm, which may be caused by:

  • Heart disease
  • Abnormal heart valve, such as mitral valve prolapse
  • Abnormal blood level of potassium
  • Certain medicines, including those used to treat asthma, high blood pressure, or heart problems
  • Overactive thyroid
  • Low level of oxygen in your blood

Things you can do to limit palpitations include:

  • Lower your intake of caffeine and nicotine. This will often reduce heart palpitations.
  • Learn to reduce stress and anxiety. This can help prevent palpitations and help you better manage them when they occur.
  • Try deep relaxation or breathing exercises.
  • Practice yoga, meditation, or tai chi.
  • Get regular exercise.
  • Do not smoke.

Why do i feel like my heart is pounding

Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.

If you have never had heart palpitations before, see your provider.

Call 911 or the local emergency number if you have:

  • Loss of alertness (consciousness)
  • Chest pain
  • Shortness of breath
  • Unusual sweating
  • Dizziness or lightheadedness

Call your provider right away if:

  • You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
  • You have heart disease or risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
  • You have new or different heart palpitations.
  • Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
  • You have related symptoms, such as chest pain, shortness of breath, feeling faint, or loss of consciousness.

Your provider will examine you and ask questions about your medical history and symptoms.

You may be asked:

  • Do you feel skipped or stopped beats?
  • Does your heart rate feel slow or fast when you have the palpitations?
  • Do you feel a racing, pounding, or fluttering?
  • Is there a regular or irregular pattern to the unusual heartbeat sensations?
  • Did the palpitations begin or end suddenly?
  • When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
  • Do you have any other symptoms?

An electrocardiogram may be done.

If you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.

If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:

  • Holter monitor for 24 hours, or another heart monitor for 2 weeks or longer
  • Echocardiogram
  • Electrophysiology study (EPS)
  • Coronary angiography

Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing

Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 10.

Miller JM, Tomaselli GF, Zipes DP. Diagnosis of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli, GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 35.

Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Why is my heart pounding for no reason?

Most of the time, they're caused by stress and anxiety, or because you've had too much caffeine, nicotine, or alcohol. They can also happen when you're pregnant. In rare cases, palpitations can be a sign of a more serious heart condition. If you have heart palpitations, see your doctor.

How can I calm my pounding heart?

How can I manage heart palpitations and anxiety?.
Coping with stress..
Diaphragmatic breathing..
Exercising regularly..
Getting enough sleep..
Meditation..
Pursed-lip breathing..
Tai chi, yoga or other mindful movement..

Why does my heart feel like its thudding?

Causes of heart palpitations lack of sleep. stress and anxiety. medicines (check the leaflet that comes with the medicine) alcohol, caffeine, nicotine and recreational drugs.