Is it possible to get heart palpitations due to anxiety?

Question

Hello doctor,

For more than a year, I have often experienced heart palpitations or a feeling that my heart skips a beat. Sometimes it is very mild, sometimes it is very intense and scary, feeling like I am having a heart attack. It comes and goes; on certain days, I experience it 20 times a day, while in other weeks, I notice nothing. It often happens when I am calm and in a relaxing situation, which is even weirder. I went to get an EKG, ultrasound, and everything was normal. I was told that it is just anxiety. Is it possible to experience such strong heart palpitations solely because of anxiety?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I want to reassure you that you have taken all the right steps so far by getting an EKG (electrocardiogram), echocardiogram, and Holter monitor, which are the key tools we use to rule out structural or rhythm-related heart disease.

The fact that these tests were normal is very reassuring and strongly supports the likelihood that your palpitations are benign in origin, often due to premature atrial or ventricular contractions (PACs or PVCs), which can feel like skipped beats, thuds, or flutters. These can be exacerbated by stress, caffeine, dehydration, lack of sleep, or anxiety, and yes, anxiety alone can cause very real and sometimes frightening palpitations, even when you are calm, because of how the autonomic nervous system works.

When your body is hyper-alert or sensitive, these sensations become more noticeable. That said, if your symptoms are disruptive or worsening, we can consider longer-term rhythm monitoring (like a 30-day event monitor or wearable ECG (electrocardiogram) device) and check for triggers with basic labs (electrolytes, thyroid function).

Lifestyle measures like limiting caffeine and alcohol, ensuring regular hydration and sleep, deep breathing techniques, or even cognitive behavioral therapy (CBT) can make a big difference. In some cases, if palpitations are truly interfering with daily life, a low-dose beta blocker may be considered to calm the heart’s response.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.