Why does panic disorder cause palpitations?

A panic attack switches on the fight-or-flight response. Adrenaline can make the heart beat faster and more strongly, while fear makes normal changes in rhythm feel especially prominent. People may describe pounding, fluttering, racing or skipped beats. Palpitations is a very common presentation of Panic Disorder, yet palpitations can also arise from heart rhythm problems, medicines, stimulants, fever or thyroid conditions.

Sit down if you feel unsteady and focus on a slow, comfortable breath rather than trying to force your heart to slow. Reduce caffeine, nicotine and other stimulants if they seem to bring on episodes. Keeping a symptom note can help: record the activity, feeling, medicines or drinks beforehand, the heartbeat sensation and any associated dizziness or pain.

Get urgent medical help for palpitations with chest pressure or pain, fainting, severe shortness of breath, marked weakness, or a sustained fast heartbeat that feels unwell. Book a medical review for new, repeated or changing palpitations, including episodes that happen without anxiety. Assessment may include a history, examination and tests chosen for your symptoms.

Ask what features point toward panic attacks and whether your symptoms need a heart rhythm check. Bring a list of prescription medicines, over-the-counter products, supplements and stimulants. You can also ask about talking therapies and other approaches for preventing panic episodes.