Heart Palpitations and Normal Heart Rate: Skipped Beats, AFib, and When to Get an EKG
Most palpitations, a pounding, fluttering or skipped beat, are harmless. Here's what a normal heart rate is, what causes palpitations, and the signs that need an EKG or 911.
A normal resting heart rate for adults is 60 to 100 beats per minute, and lower in fit people. Palpitations, a pounding, racing, fluttering or skipped-beat feeling, are very common and usually harmless, often set off by caffeine, stress, dehydration, alcohol or a cold medicine. An irregular, often fast heartbeat that keeps going can be atrial fibrillation (AFib), which needs an EKG and treatment. Palpitations with chest pain, fainting or shortness of breath need 911.
Normal heart rates
- Adults at rest: 60 to 100 beats per minute
- Athletes: often 40 to 60
- Children: higher, and the younger the child, the faster
- Your heart rate rises with exercise, stress, fever, dehydration and altitude
To check, count your pulse at the wrist or neck for 30 seconds and double it, while sitting quietly.
Common causes of palpitations
- Caffeine, energy drinks and nicotine
- Stress, anxiety and panic attacks. See our post on panic attacks vs. heart problems.
- Alcohol
- Dehydration, including at altitude
- Lack of sleep
- Decongestants, asthma inhalers, some diet pills and supplements
- Fever, anemia or an overactive thyroid
- Pregnancy and hormone changes
- Extra beats from the top or bottom chambers of the heart, which feel like a skipped or "flip-flop" beat and are usually harmless
Atrial fibrillation (AFib)
AFib is an irregular, often fast heartbeat from the top chambers of the heart. It can cause:
- An irregular, fluttering or racing heartbeat
- Tiredness or weakness
- Shortness of breath
- Dizziness
- No symptoms at all, in some people
AFib raises the risk of stroke, so it needs to be diagnosed and treated, often with medicine to control the rate and prevent clots. It's more common after 60 and with high blood pressure, heart disease, sleep apnea and heavy drinking.
What helps ordinary palpitations
- Cut back on caffeine, alcohol and nicotine
- Drink enough water
- Get enough sleep
- Practice slow breathing or relaxation
- Review your medicines and supplements with a clinician
What urgent care can do
A clinician can check your pulse and blood pressure, do an EKG to look at your heart rhythm, and check for causes like dehydration. An EKG only shows the rhythm at that moment, so if palpitations come and go, you may need a longer monitor arranged with a primary care provider or cardiologist. Our post on EKGs at urgent care explains more.
At an AfterOurs clinic, a standard self-pay visit is $175, a visit with one moderate service such as an EKG is $250, and a self-pay in-clinic visit never costs more than $330. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See the cost and insurance page.
Call 911 if palpitations come with chest pain or pressure, fainting or nearly fainting, shortness of breath, confusion, or weakness or numbness on one side; or if your heart is racing above about 150 beats a minute at rest and won't slow down.
Where to find us
Four clinics across metro Denver, all ages welcome, se habla español:
- Hampden (Southeast Denver): 8 AM–11 PM daily
- Littleton: 8 AM–11 PM daily
- Thornton: 8 AM–11 PM daily
- Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM
Walk in, or book online.
Medically reviewed by Peter Martinuzzi, MD
This article is general health information, not medical advice for your situation. If you are worried, come in or book a telehealth visit — and if it is an emergency, call 911.