Are palpitations always a sign of heart disease?

Palpitations: Could be as simple as sinus tachycardia or as serious as atrial fibrillation or svt. Needs further evaluation including ekg, holter and labs.

Palpitations: These are caused by many things. Stress, excitement, irritants both physical and chemical, pressure like a hiatal hernia or esophageal push or pull, and primary heart things, the causes are very many in number.