context: A heart palpitation is when you feel a fast-beating, pounding, or skipping heartbeat. Most of the time, there's no reason to worry. But sometimes palpitations can be signs of trouble. Many say a palpitation feels like a heaviness in the chest, head, or even the neck. Sometimes there's a flip-flopping in the chest or the throat, or the heart may stop or skip for a brief second. The answer is yes when you're also having shortness of breath, severe chest pain, heavy sweating, and dizziness, or you feel like you're going to pass out. You might be having a heart attack. Don't drive yourself to the hospital. Let an ambulance come to you. Paramedics can begin treatment as soon as they arrive. You'll get help sooner than if you go to the ER on your own. Yes, if your pulse is more than 100 beats per minute and you've not been exercising and don't have a fever. Yes, too, if you have: Palpitations coming in groups of three or more, or if they keep happening High cholesterol, diabetes, or high blood pressure -- you're at risk for heart disease New or different palpitations Stress Exercise Caffeine Alcohol Hormones How does each of these contribute to heart palpitations? Stress: When you're in a stressful situation, your body releases the hormone adrenaline. That temporarily speeds up your heart rate and breathing, and raises your blood pressure. If you're under pressure for a long time, your heart may continue to beat faster than normal, or trigger extra beats. Exercise: Your heart rate rises when you work out hard. So you might feel palpitations before and after exercising, but not during -- that's because you won't notice the extra heartbeats when your heart rate is up. When you stop working out, your heart rate slows down again, but your adrenaline level stays high. That's when you may feel your ticker beating extra-fast. It could be a warning sign of something serious. Call 911 if you also have: Shortness of breath Chest pain Extreme lightheadedness Caffeine: It's what doctors call a stimulant. It revs up your heartbeat. You may have more of it in your system than you think. You'll find caffeine not only in coffee and tea, but also in: Coffee drinks like lattes and cappuccinos Sodas (even some non-cola ones) Energy drinks Chocolate Some over-the-counter cold medications -- often the "non-drowsy" formulas Caffeine causes your brain to release adrenaline, and that speeds up your heart rate. Some people are more sensitive to it than others. But if you had a lot of caffeinated drinks in one day -- and you're also feeling tired and stressed out -- you could end up with heart palpitations and extra, early beats. Alcohol: Drinking raises your odds of having an irregular heartbeat. Heavy drinking, like a binge, can bring on an episode if you haven't had one before. Wine and liquor are more likely to cause problems than beer. Hormones: Hormone changes that come with menstruation, pregnancy, and menopause can bring on heart palpitations. Take notes on what was going on before your palpitations began. Bring the notes with you to your doctor's appointment. He may suggest you have an electrocardiogram (also called an EKG). This test shows the electric activity in your heart and its rhythm. This information can help your doctor understand what might be going on. Having extra, early beats usually isn't dangerous, but it can be frustrating. It affects some people's quality of life. But once you know what triggers it, you can take steps to treat it and feel better. Unless your doctor finds another heart condition, she probably won't suggest treatment for your heart palpitations. If your symptoms or condition does require treatment, your doctor will probably try one of these methods: Medications: Antiarrhythmic drugs like beta-blockers and calcium channel blockers are a good starting point. Sometimes, these drugs don't work as well. You might need stronger antiarrhythmic drugs that directly act on the sodium and potassium channels of the heart. Catheter ablation : Your doctor will thread small wires through your leg veins and into your heart. This will trigger an arrhythmia, and your doctor will identify the area and send energy to cause scars and stop the irregular beat. Electrical cardioversion : The doctor gives your heart a shock to get its rhythm back to normal. The best way to stop palpitations is to make sure they never start: Lower stress. Try relaxation techniques, such as meditation, yoga, or deep breathing. Avoid stimulants. Caffeine, nicotine, certain cold medicines, and even energy drinks can cause an irregular heartbeat. Don't use illegal drugs. Certain drugs, such as cocaine and amphetamines, can lead to palpitations.