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Common Causes While there many possible causes of heart palpitations, the most common factors behind them include: Stress and anxiety Sleep deprivation Stimulants like caffeine and nicotine Alcohol consumption Certain medications (consult with your doctor) Intense exercise Pregnancy Thyroid conditions Heart Palpitations Are Common and Most Go Away on Their Own While heart palpitations can be a symptom of a serious condition like arrhythmia or atrial fibrillation, they are usually not cause for concern and do not always require treatment