Many things can cause heart palpitations. You can even be aware of your heart beat when it is actually beating normally. In most cases, heart palpitations are not a sign of underlying disease. However, in some cases they can be a sign of serious heart problems.

Several things can trigger palpitations, including strong emotions, anxiety, physical activity, caffeine, alcohol, nicotine, certain medicines (such as pseudoephedrine), hormonal changes, and some medical conditions including anemia. These things all tend to make the heart beast faster and/or stronger than normal but despite the sensation, the heart is still working normally.

Sometimes palpitations can be symptoms of arrhythmias, which are problems with the speed or rhythm of the heartbeat. Arrhythmias may themselves be signs of underlying heart dysfunction such as coronary artery disease, heart attack, heart failure, or heart valve problems. Most people with heart palpitations do not have arrhythmias, but if you experience palpitations you should see your doctor to be checked out.