Stress gets blamed for a lot—and sometimes unfairly. While stress can trigger palpitations, certain patterns raise concern for an underlying arrhythmia, or abnormal heart rhythm.
What arrhythmia-related palpitations often feel like
Rhythm-driven palpitations tend to have a signature:
- Sudden start and sudden stop, like flipping a light switch
- A very fast rate that feels too fast to count
- A regular, pounding rhythm, not just random skips
- Episodes lasting minutes to hours
- Occurring at rest or during sleep
- Repeating in the same exact way each time
These features suggest the heart’s electrical system may be stuck in a loop or misfiring.
Common rhythm culprits (in plain language)
- PACs/PVCs: Extra beats—often benign but sometimes frequent enough to feel miserable
- SVT (Supraventricular Tachycardia): A short-circuit that causes sudden, steady racing
- Atrial fibrillation (AFib): Chaotic electrical signals; often irregular and exhausting
- Atrial flutter: A more organized loop rhythm that feels fast and steady
- Inappropriate sinus tachycardia or POTS-like patterns: The normal pacemaker runs too fast for the situation, more common in women
You don’t need to diagnose which one it is—but recognizing the pattern helps guide evaluation.
Red flags that need urgent evaluation
Seek urgent care if palpitations are associated with:
- Fainting or near-fainting
- Chest pressure or pain
- New or severe shortness of breath
- Neurologic symptoms (weakness, trouble speaking)
- Known heart disease with new palpitations
When in doubt, treat palpitations as real until proven otherwise.
The most common mistake
A normal EKG in the office does not rule out a rhythm problem. Arrhythmias are intermittent. If they’re not happening during the test, they won’t show up.
Looking for an arrhythmia without capturing it is like trying to prove lightning doesn’t exist because the sky is clear.
The takeaway
Stress can trigger palpitations—but stress is not a diagnosis. Recurrent, sudden, or intense episodes deserve a real rhythm evaluation.
Next, we’ll walk through exactly how cardiologists figure out what’s happening and what to do next.
Call 352-504-3500 or request an appointment at www.tc-heart.com to schedule a palpitations or rhythm evaluation with Dr. Pedro Adrover at Tri County Heart Institute.
Medical disclaimer: This article is for education only and does not replace medical advice. Seek emergency care for severe symptoms.
