Anxiety is a common psychological state involving feelings of worry, nervousness, or unease, often about an uncertain outcome. This state frequently manifests as physical symptoms, including changes in heart rhythm, often described as an irregular heartbeat or arrhythmia. Arrhythmia refers to sensations like a racing pulse or feeling the heart flutter or pound, medically known as palpitations. The connection between anxiety and these cardiac sensations is widely recognized, confirming that stress directly influences heart function. Many people experiencing intense anxiety worry that these physical symptoms signal a serious underlying medical condition.
The Sympathetic Nervous System and Heart Rate
The physiological link between anxiety and heart changes is rooted in the autonomic nervous system, the body’s involuntary control system. When anxious, the body interprets the stress as a physical threat, activating the sympathetic nervous system and triggering the “fight or flight” response.
This response involves the rapid release of stress hormones, norepinephrine and epinephrine, from the adrenal glands. These hormones circulate and interact directly with the heart’s electrical system and muscle tissue. They bind to receptors on heart cells, significantly increasing the rate and force of heart muscle contraction.
This surge delivers more oxygenated blood to the muscles. The stress hormone cortisol can also maintain this heightened state, keeping the heart rate and blood pressure elevated. When triggered by anxiety, this mechanism translates the mental state into noticeable physical changes, and the increased electrical activity can destabilize the heart’s natural rhythm.
Describing Anxiety-Related Cardiac Sensations
Stress hormones directly stimulate the heart, resulting in specific sensations commonly associated with an irregular heartbeat. The most frequent sensation is tachycardia, a rapid heart rate that feels like pounding or racing in the chest, throat, or neck. This results directly from the sympathetic nervous system increasing the firing rate of the heart’s natural pacemaker.
Another common experience is palpitations, general feelings of the heart beating uncomfortably fast, hard, or irregularly. These can feel like a “skipped beat” or a strong “thump” in the chest, often identified as premature ventricular contractions (PVCs). PVCs are extra heartbeats originating in the lower chambers.
The extra beat occurs early, followed by a brief pause as the heart resets, and then a stronger beat. These irregularities are frequently triggered by increased adrenaline levels associated with anxiety. While these sensations can be frightening, they are generally harmless when caused directly by an anxiety response.
Distinguishing Anxiety from Primary Heart Conditions
While anxiety causes alarming cardiac sensations, it is important to recognize warning signs that may indicate a primary cardiac condition. Symptoms warrant medical attention if they occur during periods of rest or minimal exertion, rather than only during peak anxiety.
Chest pain that is crushing, squeezing, or heavy and radiates to the arm, jaw, or back is highly concerning for a cardiac event. This differs from the sharper, more fleeting pain often linked to anxiety. Other red-flag symptoms include fainting (syncope), severe shortness of breath not explained by hyperventilation, or symptoms persisting long after the anxiety trigger has passed.
A medical evaluation is the only definitive way to distinguish between anxiety-induced symptoms and a true structural heart issue. Diagnostic tools include an electrocardiogram (EKG) or a wearable heart monitor (Holter monitor). These tests record the heart’s electrical activity during a symptomatic period to rule out conditions like Atrial Fibrillation or other severe arrhythmias. Consulting a doctor ensures any serious underlying heart condition is identified and treated.