A fluttering sensation in your chest typically isn't cause for concern, especially if you don't have any other symptoms. Still, though, having a heart flutter that causes you to cough can seem worrisome. So what's going on?
"Most often, heart palpitations or symptoms of feeling one's heartbeat are benign and associated with increased adrenaline or stress," says Shephal Doshi, MD, cardiac electrophysiologist and director of cardiac electrophysiology and pacing at Providence Saint John's Health Center.
It's normal for heart palpitations to feel like a flip-flopping, pounding or even fluttering sensation in the chest that can trigger an urge to cough. But why exactly is a heart flutter causing you to cough?
"When the heart feels like it is beating funny, maneuvers that increase the pressure in the chest — like coughing or bearing down — can reset the heartbeat and make the heart feel normal again," Dr. Doshi says.
Here are the most common culprits behind a heart flutter or cough sensation in the chest and when to call the doctor.
It's not uncommon for stress or worry to make your heart race, and this irregular heartbeat can be followed by a cough. Anxious feelings can engage your body's fight-or-flight response, which temporarily increases blood flow and speeds up your heartbeat, according to the Cleveland Clinic.
Also: Try not to get anxious about your heart. A racing or pounding sensation can be a normal response to anxiety, and getting worked up about it will only make the problem worse, Dr. Doshi says.
You can also differentiate a stress-induced racing heart from an underlying heart rhythm problem by the presence (or lack) of other symptoms.
"It can sometimes be hard to tell if what you are feeling is awareness of a normal heartbeat or a heart rhythm problem," says Harmony Reynolds, MD, director of the Sarah Ross Soter Center for Women's Cardiovascular Research at NYU Langone Health and volunteer expert for the American Heart Association's Go Red for Women movement.
"We worry about fluttering most when people feel dizzy or lightheaded at the same time, have pain in the chest or pass out," she says.
Added an extra shot of espresso to your morning latte? Caffeine is a stimulant that signals the release of fight-or-flight hormones like adrenaline, which in turn can cause heart flutters or palpitations, Dr. Doshi says.
If the caffeine-induced fluttering in your chest makes you cough, that's likely your body's way of resetting your heartbeat, Dr. Doshi says.
And coffee isn't the only culprit. Caffeinated foods and beverages like chocolate, soda and energy drinks can also make your heart beat faster. Drugs like nicotine, amphetamines and cocaine can likewise have that effect, per the Mayo Clinic.
3. Medication or Supplements
Some common meds list heart palpitations as a possible side effect, according to the Cleveland Clinic. These include:
- Allergy, asthma and cold medicines
- Diet pills
- Heart disease medications
- High blood pressure medications
- Thyroid medications
Some vitamins and herbal supplements can also affect your heart, per the Cleveland Clinic, such as:
- Bitter orange
Let your doctor know if a drug or supplement is affecting your heartbeat — they may be able to adjust your dose, switch your medication or recommend if you should stop taking a certain supplement.
In some cases, even mild dehydration can cause a rapid heartbeat. Running low on fluids and electrolytes can force the heart to work harder, creating a pounding or racing sensation, according to the U.S. National Library of Medicine (NLM).
Other signs of serious dehydration include:
- Rapid breathing
If you or someone else is experiencing these symptoms, seek medical attention immediately, per the NLM.
How to Stay Hydrated
Use this equation to determine how much water you should drink every day to avoid dehydration (and, potentially, heart palpitations and coughing):
Body weight (in pounds) ÷ 2 = minimum ounces of water you should drink per day
A fever, like stimulants, can signal the release of the hormone adrenaline, which can raise your heart rate and potentially be the reason why you cough when your heart flutters, Dr. Doshi says. (Heart palpitations caused by a fever do not mean the infection that caused the fever has invaded your heart, he adds.)
Taking an over-the-counter fever reliever like acetaminophen or ibuprofen can help bring down your temperature, which in turn should help with the palpitations or a flutter in your chest that makes you cough, he says.
6. Hormone Changes
Hormone shifts tied to your period, menopause or pregnancy can all make your heart feel like it's fluttering or pounding, according to the Mayo Clinic.
Heart palpitations during pregnancy are especially common due to higher blood volume, per the Cleveland Clinic. Most of the time, these flutters are totally harmless — however, it's never a bad idea to bring up heart palpitations during pregnancy to your doctor.
Similarly, you can alert your doctor if heart palpitations make you cough (whether that's related to pregnancy or otherwise). "Some people feel that they need to cough when they have a fluttering sensation in the chest," Dr. Reynolds says. "If you feel that, try to notice if the cough makes the flutter feeling go away, and tell your doctor."
Pregnant or not, if you have heart palpitations and other symptoms like chest pain, difficulty breathing, dizziness or confusion, seek medical care immediately, per the Cleveland Clinic.
7. Alcohol Use
Though moderate drinking is tied to some health benefits, excessive alcohol consumption can increase your risk for heart rhythm disorders like atrial fibrillation (Afib), per a July 2014 analysis in the Journal of the American College of Cardiology.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as:
- People assigned male at birth (AMAB): More than 4 drinks per day or more than 14 drinks per week
- People assigned female at birth (AFAB): More than 3 drinks per day or more than 7 drinks per week
According to the Centers for Disease Control and Prevention (CDC), other possible Afib symptoms include:
- Shortness of breath
- Low energy
- Chest pain
Visit your doctor if you show symptoms of this condition, as they can prescribe medicine to control your heart rhythm and reduce the risk for complications, per the CDC.
Stick to the NIAAA-recommended upper limit of two drinks per day for people AMAB and one drink per day for people AFAB.
Rapid heartbeat is a common symptom of anemia, according to the Mayo Clinic. Other signs of the condition include:
- Extreme fatigue
- Pale skin
- Shortness of breath
- Cold hands and feet
"Being anemic means having low red blood cells to carry oxygen," Dr. Doshi says. "When that happens, the body signals the heart to pump more blood by releasing more adrenaline, which makes the heart beat faster."
These heart palpitations may in turn trigger a cough urge as your body attempts to reset your heartbeat, he says.
Treating the anemia depends on the cause, which is why it's important to talk to your doctor if you're having the above symptoms. If the culprit is iron deficiency, treatment may involve taking iron supplements, which should make the palpitations go away, per the Mayo Clinic.
9. Thyroid Disorder
- Unexplained weight loss
- Increased appetite
- Nervousness or irritability
Treatments vary but can include anti-thyroid medications, beta blockers, radioactive iodine or surgery, according to the Mayo Clinic.
10. Irregular Heartbeat
When a fast or pounding heartbeat or heart flutter that causes cough can't be attributed to other causes, arrhythmia — a problem with the rate or rhythm of the heart's beat — may be to blame, Dr. Doshi says.
There are several types of arrhythmias, including conditions that make your heart beat too fast or too slow, according to the Mayo Clinic. Making the diagnosis typically involves seeing a cardiologist for an electrocardiogram, which records the heart's electric signals.
Treatment depends on the type of arrhythmia and other factors. "Sometimes a person doesn't need to be treated, sometimes they need to add or remove medications or reduce their alcohol or caffeine intake," Dr. Doshi says.
In some cases, you may require surgery to stop the heart from short-circuiting, he says.
When to See a Doctor About Heart Palpitations
Occasional heart palpitations or flutters that make you cough but go away quickly typically don't warrant a call to the doctor. But you should let your doctor know if you have frequent heart palpitations or if you have a history of heart disease, according to the Mayo Clinic.
Finally, seek emergency medical attention for heart palpitations with chest pain, fainting, dizziness or trouble breathing. These could be signs of a heart attack or another serious heart problem.
- Cleveland Clinic: "Heart Racing? How Anxiety Causes Heart Palpitations"
- Cleveland Clinic: "Heart Palpitations After Eating"
- U.S. National Library of Medicine: "Fluid and Electrolyte Balance"
- U.S. National Library of Medicine: "Dehydration"
- Journal of the American College of Cardiology: "Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis"
- Centers for Disease Control and Prevention: "Atrial Fibrillation"
- Mayo Clinic: "Anemia"
- Harvard Health Publishing: "Thyroid Hormone: How It Affects Your Heart"
- Mayo Clinic: "Hyperthyroidism (Overactive Thyroid)"
- Mayo Clinic: "Caffeine: How much is too much?"
- Cleveland Clinic: "Heart Palpitations in Pregnancy"
- National Institute on Alcohol Abuse and Alcoholism: "Drinking Levels Defined"
- Mayo Clinic: "Heart Arrythmia"
- Mayo Clinic: "Heart palpitations"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.