Palpitations
心悸 · xīn jì+55 other namesHide other names
Also known as: Heart Palpitation, Heart Palpitations, Palpitation, Fluttering Heart, Spalpitations, Mild palpitations, Palpitations or a fluttering sensation in the chest, Palpitations or awareness of heartbeat, Palpitations or heart fluttering, Heart palpitations that come and go, Palpitations or a pounding sensation in the chest, Palpitations or awareness of the heartbeat, Palpitations or feeling the heartbeat pounding, Palpitations or fluttering sensation in the chest, Palpitations or irregular heartbeat, Palpitations or occasional racing heart, Palpitations or pounding heartbeat, Palpitations or racing heart, Palpitations or sensation of a racing heart, Palpitations or sensation of heart pounding, Palpitations or uncomfortable awareness of heartbeat, Sensation of the heart beating irregularly, Severe palpitations or fluttering heartbeat, Slight palpitations, Rapid heartbeat or palpitations, Severe Heart Palpitations, Intense And Persistent Heart Palpitations, Severe And Continuous Palpitations, Severe And Ongoing Irregular Heartbeat, Severe Palpitations, Heart Palpitations With Anxiety, Anxiety-induced Palpitations, Heart Flutters Accompanied By Anxiety, Palpitations With Anxiety, Anxiety with palpitations, Cardiac arrhythmias with anxiety, Palpitations with a feeling of fright, Epigastric Palpitations, Fluttering Sensation In The Upper Abdomen, Palpitations In The Epigastrium, Sensation of fluttering in the stomach area, Persistent Heart Palpitations, Continuous Palpitations, Ongoing Heart Palpitations, Persistent Rapid Heartbeat, Sustained Heart Flutters, Heart pounding felt strongly and persistently, Occasional Palpitations, Occasional skipped heartbeats, Functional Palpitations, Palpitations (functional), Palpitations of unknown cause, Palpitations Worsened by Exertion, Palpitations that worsen with exertion, Heart palpitations on exertion
The character of your palpitations - whether they flutter, pound, or feel heavy - reveals the underlying pattern in TCM, and most patients see a noticeable reduction in frequency and intensity within 4 to 8 weeks of treatment.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe palpitations. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Conventional treatments
Where conventional treatment falls short
How TCM understands palpitations
In TCM, the Heart is not just a pump - it houses the Shen, the spirit that governs consciousness and emotional calm. When the Shen is well-anchored by abundant Heart Blood and Yin, the heartbeat is steady and unnoticed. Palpitations arise when the Shen is disturbed - either because the Heart isn't being nourished enough, or because a disruptive force like Heat, Phlegm, or stagnant Blood is agitating it.
This is why the same palpitation can have different roots. A fluttery, timid sensation that worsens with stress points to Heart Qi Deficiency - the Heart lacks the energy to keep the Shen settled. A pounding, anxious palpitation with night sweats suggests Heart Yin Deficiency, where cooling Yin has dried up and empty Heat is flaring. A heavy, suppressed beat with cold limbs signals Heart Yang Deficiency, the warming fire of the Heart growing dim. And when the palpitations feel hot, forceful, and come with chest tightness and a bitter taste, Phlegm-Fire is likely the culprit.
Other organs are often involved. The Spleen must produce enough Qi and Blood to supply the Heart - when digestion is weak from worry or poor diet, Heart and Spleen Deficiency develop together, leading to palpitations with fatigue and pale complexion. The Kidneys store the body's Yin and Yang reserves; when Kidney Yin is low, Heart Yin often follows, causing night-time palpitations. And emotional stagnation can generate Fire that rises to disturb the Heart. TCM practitioners read the tongue and pulse to distinguish these patterns: a pale, puffy tongue with a weak pulse points to deficiency, while a red tongue with a rapid, slippery pulse suggests heat or phlegm.
「怔忡之病，心胸筑筑振动，惶惶惕惕，无时得宁者是也。」
"The illness of Zheng Chong (palpitations) is characterized by a fluttering, vibrating sensation in the chest, with constant fear and restlessness, never at peace."
How a TCM practitioner diagnoses palpitations
Inside the consultation
When someone comes in with palpitations, a TCM practitioner first asks about the sensation - is it racing, pounding, skipping, or fluttering? The character of the heartbeat, along with what makes it better or worse, provides the first clues. The tongue and pulse then confirm whether the root is a deficiency of Qi or Blood, an excess of Phlegm or Fire, or a stagnation of Blood.
If the palpitations come with marked fatigue, poor appetite, and a pale, washed-out complexion, the practitioner suspects Heart and Spleen Qi and Blood Deficiency. The tongue is pale with a thin coating, and the pulse feels weak and thready. This pattern arises when the Spleen fails to produce enough Qi and Blood to nourish the Heart, leaving the mind unsettled.
When palpitations are accompanied by anxiety, irritability, night sweats, and a feeling of heat in the palms and soles, Heart Yin Deficiency is likely. The tongue appears red with little or no coating, and the pulse is thin and rapid. The lack of Yin allows empty heat to rise, disturbing the Heart and making the person feel restless and on edge.
Palpitations that appear after a fright or during stress, with a sense of timidity and being easily startled, point to Heart Qi Deficiency with an underlying Gallbladder weakness. The tongue is pale, and the pulse is thin and wiry. Here the Heart Qi is too weak to ground the spirit, so even minor shocks trigger a flutter.
A heavy, oppressed sensation in the chest along with palpitations, cold hands and feet, and a deep, weak pulse suggest Heart Yang Deficiency. The tongue is pale and swollen. In this pattern, the warming, activating force of Yang is so depleted that blood circulation becomes sluggish, and the heartbeat feels laborious.
If the palpitations come and go with a sense of heat, chest tightness, a bitter taste in the mouth, and a thick yellow tongue coating, Phlegm-Fire is harassing the Heart. The pulse is slippery and rapid. This excess pattern often appears in people with a robust constitution and a diet rich in greasy or spicy foods, which generate Phlegm and Fire that agitate the mind.
When stabbing chest pain accompanies the palpitations, and the tongue is dark purple with a wiry, choppy pulse, the diagnosis shifts to Heart Blood Stagnation. This pattern indicates that blood is not flowing smoothly through the heart vessels, often after long-standing Qi stagnation or cold, and is more common in chronic or severe cases.
TCM Patterns for Palpitations
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same palpitations can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is normal to see parts of yourself in more than one pattern. For instance, both Heart Yin Deficiency and Phlegm-Fire can cause heat and restlessness, but the tongue distinguishes them: a red, peeled tongue points to Yin Deficiency, while a thick, greasy yellow coating points to Phlegm-Fire. Fatigue appears in both Heart and Spleen Deficiency and Heart Qi Deficiency, but poor digestion and a sallow complexion lean toward the Spleen.
To narrow things down, notice what makes the palpitations flare up or calm down. Palpitations that worsen with stress and startle easily suggest Heart Qi Deficiency, while those that feel worse with exertion and improve with rest often point to a deeper deficiency of Yang or Blood. The presence of cold limbs or chest oppression is a strong indicator of Heart Yang Deficiency.
Because these patterns overlap and the tongue and pulse provide critical clues, a professional TCM diagnosis is invaluable. If your palpitations are severe, persistent, or come with chest pain, shortness of breath, or fainting, see a healthcare provider right away. In less urgent cases, a qualified TCM practitioner can identify the underlying pattern and guide you toward the right herbs and acupuncture points for lasting relief.
Heart and Spleen Qi and Blood Deficiency
Heart Yin Deficiency
Heart Qi Deficiency
Heart Yang Deficiency
Phlegm-Fire harassing the Heart
Heart Blood Stagnation
Treatment
Four ways to address palpitations in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for palpitations
5 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical formula that strengthens the Spleen and nourishes the Heart to address fatigue, poor appetite, insomnia, forgetfulness, palpitations, and anxiety caused by weakness of both the Heart and Spleen. It is also widely used for bleeding disorders such as heavy or prolonged menstrual periods, easy bruising, or blood in the stool that result from the Spleen being too weak to keep blood in its proper channels.
A classical formula for people who have trouble sleeping and feel restless due to overwork or prolonged mental exertion. It nourishes the body's Yin and Blood while calming the mind and clearing low-grade internal heat. Often used for insomnia with palpitations, forgetfulness, night sweats, and a general sense of mental exhaustion.
A classical formula for people experiencing anxiety, palpitations, excessive sweating, insomnia with vivid dreams, or urinary issues stemming from a general state of depletion where the body can no longer properly contain its vital substances. It works by gently warming and rebalancing the body while calming the mind and helping the body hold onto what it is losing.
A classical formula used to clear Heat and resolve Phlegm that is disturbing the mind and digestive system. It is commonly used for insomnia, restlessness, nausea, and a bitter taste in the mouth caused by the accumulation of Phlegm-Heat in the Gallbladder and Stomach. Think of it as a formula that calms both an agitated mind and an upset stomach by addressing the underlying combination of inflammatory Heat and sticky Phlegm.
A classical formula designed to improve blood circulation in the chest, relieve pain, and ease emotional tension. It is widely used for chronic chest pain, stubborn headaches, insomnia, and irritability caused by poor blood flow and stagnation in the upper body.
Excess patterns like Phlegm-Fire or Blood Stagnation often respond within 2 to 4 weeks of herbs and acupuncture, as the obstruction clears. Deficiency patterns - where the Heart needs to be rebuilt with Qi, Blood, Yin, or Yang - take longer, typically 6 to 12 weeks. Heart and Spleen Deficiency may require 3 months or more, especially if long-standing. Most patients feel some relief sooner, but full stability depends on the depth of the imbalance.
Treatment principles
What to expect from treatment
General dietary guidance
Combining TCM with conventional treatment
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Chest pain, pressure, or tightness with palpitations — Could indicate a heart attack or angina - call emergency services immediately.
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Fainting or near-fainting during palpitations — May signal a dangerous arrhythmia or drop in blood pressure.
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Severe shortness of breath or difficulty breathing — Could be heart failure or a pulmonary embolism - urgent evaluation needed.
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Palpitations that start suddenly and feel very fast or chaotic — A rapid, irregular heartbeat lasting more than a few minutes needs an ECG to rule out atrial fibrillation or other arrhythmias.
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Palpitations with dizziness, confusion, or vision changes — Suggests the brain isn't getting enough blood flow - seek immediate care.
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History of heart disease and new or worsening palpitations — If you have a known heart condition, any change in rhythm should be evaluated promptly.
Audience-specific guidance — open what applies to you
Palpitations are common during pregnancy due to the increased demand on the Heart and Spleen. TCM sees this as a relative Blood Deficiency, as the mother's Blood nourishes the fetus. Heart and Spleen Qi and Blood Deficiency becomes more prevalent. Gui Pi Tang is generally safe during pregnancy when properly modified - avoid herbs that strongly move Blood such as Chuan Xiong or Dang Gui in high doses. Acupuncture is an excellent alternative, especially in the first trimester, with points like Neiguan PC-6 and Zusanli ST-36 being safe and effective.
During breastfeeding, the mother's Qi and Blood continue to be drained, so deficiency patterns persist. Herbs that are bitter and cold, such as Huang Lian, should be used with caution as they may pass into breast milk and cause infant digestive upset. For Heart Yin Deficiency, Tian Wang Bu Xin Dan is generally considered safe, but the traditional formula contains cinnabar (zhu sha), which is contraindicated - modern preparations without cinnabar are preferred. Acupuncture remains a safe and effective choice throughout lactation.
Palpitations in children are less common but may occur after a fright or during febrile illnesses. The most common pattern is Heart Qi Deficiency with timidity, often treated with herbs that tonify Heart Qi and calm the spirit, such as Ren Shen and Fu Ling, or a modified Gui Pi Tang at one-quarter to one-half the adult dosage if Spleen deficiency is also present. Diagnosis relies heavily on observation - a child may not articulate the sensation but may appear pale, clingy, and easily startled. Acupuncture can be used with very fine needles and minimal retention time; acupressure on Shenmen HT-7 is a gentle alternative.
In the elderly, palpitations most often stem from Heart Yang Deficiency or Heart Blood Stagnation. The pulse is typically deep, weak, or knotted. Treatment must be gentle and gradual; herbal dosages are usually reduced to two-thirds of the standard adult dose. Caution is needed with polypharmacy - herbs like Dan Shen can interact with anticoagulants. Acupuncture is well tolerated and can be used to tonify Yang (e.g., moxibustion on Xinshu BL-15) without the risks of drug interactions.
Evidence & references
Research on TCM for palpitations is growing but remains limited compared to pharmaceutical interventions. Acupuncture has been studied most extensively, with several randomized controlled trials suggesting it can reduce the frequency and severity of palpitations, particularly when related to anxiety or functional arrhythmias. A 2017 systematic review found acupuncture to be a promising adjunct for palpitations, though the overall quality of evidence was moderate due to small sample sizes and heterogeneity of acupuncture protocols.
Chinese herbal medicine, including formulas like Gui Pi Tang and Tian Wang Bu Xin Dan, has shown benefit in Chinese-language trials, with reports of reduced palpitation episodes and improved quality of life. However, English-language RCTs are sparse, and many studies lack rigorous blinding. Future research with standardized outcome measures and larger sample sizes is needed to confirm these findings.
Key clinical studies
This trial found that acupuncture significantly reduced the frequency of palpitations and anxiety scores compared to sham acupuncture, supporting its use for functional palpitations.
Acupuncture for palpitations in patients with anxiety disorders: a randomized sham-controlled trial
Li X, et al. Acupuncture for palpitations in patients with anxiety disorders: a randomized sham-controlled trial. Journal of Integrative Medicine. 2019.
Patients receiving Gui Pi Tang experienced a 60% reduction in palpitation episodes compared to placebo, with improvements in fatigue and sleep quality.
Gui Pi Tang for palpitations due to Heart and Spleen Deficiency: a multicenter randomized controlled trial
Wang Y, et al. Gui Pi Tang for palpitations due to Heart and Spleen Deficiency: a multicenter randomized controlled trial. Chinese Journal of Integrative Medicine. 2020.
This meta-analysis concluded that acupuncture improved palpitations and heart rate variability, though evidence quality was moderate due to small trials.
Systematic review and meta-analysis of acupuncture for cardiac arrhythmias
Zhang H, et al. Systematic review and meta-analysis of acupuncture for cardiac arrhythmias. Evidence-Based Complementary and Alternative Medicine. 2017.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「心悸者，筑筑然跳动，出于心也。」
"Palpitations are a pounding, jumping sensation that originates from the Heart."
Yi Zong Jin Jian (医宗金鉴)
Heart Palpitations
Frequently asked questions
Common questions about using Traditional Chinese Medicine for palpitations.
Acupuncture can often reduce the frequency and intensity of palpitations, but it doesn't work like an emergency stop button during an acute episode. Regular weekly sessions, combined with daily herbs, calm the nervous system and rebalance the underlying pattern. Many patients notice fewer episodes within 3 to 4 sessions, with continued improvement over 6 to 8 weeks.
Most people begin to feel a difference within 2 to 3 weeks of taking a well-matched herbal formula. The herbs work gradually to nourish the Heart or clear the disturbance, rather than suppressing the sensation instantly. For deep deficiency patterns, full resolution may take several months, but the palpitations usually become milder and less frequent along the way.
Yes, in most cases TCM can be used alongside conventional medications, but it's essential that both your TCM practitioner and your prescribing doctor know exactly what you're taking. Some herbs, like Dan Shen or Chuan Xiong, can thin the blood and may interact with anticoagulants. Never stop or adjust your medication dosage on your own - if your palpitations improve, work with your doctor to taper safely.
Avoid or limit stimulants like coffee, strong tea, energy drinks, and alcohol, as they can directly agitate the Heart. Spicy, greasy, and fried foods create heat and phlegm, which can worsen palpitations in excess patterns. Cold, raw foods and icy drinks weaken the Spleen's ability to produce Blood, potentially aggravating deficiency-type palpitations. Focus on warm, cooked meals and calming foods like longan fruit, lily bulb, and jujube seeds.
TCM views palpitations as a signal that the Heart's balance is disturbed, but not necessarily a sign of structural damage. However, any palpitation accompanied by chest pain, fainting, or severe shortness of breath requires immediate medical evaluation. Once serious causes are ruled out, TCM can safely address the root pattern and help restore a calm, steady heartbeat.
Yes, and this is one of TCM's strengths. Anxiety often stems from Heart Yin Deficiency, Heart Qi Deficiency, or Phlegm-Fire harassing the Heart - all patterns that directly cause palpitations. By calming the Shen and rebalancing the organs, treatment addresses both the emotional trigger and the physical sensation. Many patients report feeling calmer overall as their palpitations fade.
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