17084 Heart Palpitations

Overview

Heart palpitations are the feeling that your heart is pounding, racing, fluttering, or skipping a beat. You may feel this in your chest, throat, or neck. For most people, palpitations are harmless and go away on their own, but they can sometimes be a sign of another health issue.

Yes, heart palpitations are one of the most common reasons people visit their general practitioner. Most people have them at some point in their lives.

Palpitations can affect anyone at any age, including children and older adults. They are slightly more common in women, especially during pregnancy or around menopause. People with anxiety, stress, or certain heart conditions may also be more likely to feel them.

Symptoms

Common symptoms

• A racing or pounding heartbeat
• A fluttering sensation in the chest
• The feeling that the heart skipped a beat
• An irregular or strong pulse in the neck or throat
• Discomfort or mild chest tightness (but not severe pain)

Symptoms in children

• Children may describe their heart as 'jumping' or 'fluttering'.
• Palpitations can happen after exercise, excitement, or too much caffeine.
• They are usually harmless, but see a doctor if your child also feels faint, dizzy, or has chest pain.

Symptoms in older adults

• Older adults may feel palpitations more often, especially if they have heart disease or high blood pressure.
• Symptoms may come with light-headedness, shortness of breath, or fatigue.
• Because the risk of underlying heart rhythm problems increases with age, it is important to have palpitations checked by a doctor.

Causes

Main causes

• Stress, anxiety, or a panic attack
• Too much caffeine from coffee, tea, or energy drinks
• Alcohol or nicotine use
• Dehydration or low blood sugar
• Medications such as asthma inhalers, cold remedies, or thyroid pills
• Hormone changes, including pregnancy or menopause
• Anemia (low iron) or an overactive thyroid
• Heart rhythm problems, such as atrial fibrillation or premature beats
• Heart disease or a history of a heart attack (less common)

Risk factors

• High levels of stress or anxiety
• Drinking large amounts of caffeine or alcohol
• Taking certain medications or supplements
• Having a heart condition or high blood pressure
• Being pregnant
• Having an electrolyte imbalance in your blood
• A family history of heart rhythm problems

When to see a doctor

See a doctor urgently if:

• If palpitations happen with chest pain, shortness of breath, or fainting, call for emergency help right away.
• If palpitations are very frequent, last a long time, or make you feel dizzy, see a doctor the same day.
• If you have heart disease or risk factors, do not wait to get palpitations checked.

Book a routine appointment if:

• If you have occasional palpitations that are not bothersome, bring them up at your next routine doctor’s visit.
• If you notice that palpitations started after you began a new medicine, ask your doctor or pharmacist if it could be a side effect.
• If palpitations happen every week or more, schedule an appointment to have them evaluated.

Diagnosis

Your doctor will start by asking about your symptoms, when they happen, and your overall health. They will listen to your heart and may order tests to see whether your heartbeat is normal or if there is an underlying condition causing the palpitations.

Tests that may be done

• Electrocardiogram (ECG or EKG) – a quick and painless test that records the electrical activity of your heart
• Holter monitor – a small portable device you wear for 24 to 48 hours to record your heart’s rhythm during daily activities
• Event monitor – a device you wear for a few weeks that you activate when you feel palpitations
• Blood tests – to check for anemia, thyroid problems, or electrolyte imbalances
• Echocardiogram – an ultrasound that looks at the structure and function of your heart
• Stress test – if your doctor thinks exercise or activity may trigger palpitations

What to expect at your appointment

Most of these tests are simple and non-invasive. You may need to wear a monitor for a day or two, but you can usually continue your normal routine. After the results come in, your doctor will explain what they found and whether any treatment is needed.

Treatment

Treatment depends on the cause. If palpitations are harmless and triggers are the main issue, no specific medical treatment is needed. If an underlying condition such as an overactive thyroid, anemia, or a heart rhythm problem is found, your doctor will treat that condition. The goal is always to control symptoms and reduce any risk to your health.

Self-care at home

• Reduce or avoid caffeine, alcohol, and energy drinks
• Quit smoking and avoid nicotine products
• Find healthy ways to manage stress, such as deep breathing, meditation, or gentle yoga
• Make sure you stay hydrated by drinking enough water throughout the day
• Get enough sleep and try to keep a regular sleep schedule
• Avoid recreational drugs and over-the-counter stimulants

Medical treatments

If an underlying condition is causing your palpitations, your doctor may recommend treatments such as medications to help control your heart rate or rhythm, medicines to treat an overactive thyroid or anxiety, or supplements for low iron or electrolyte imbalances. Any medication will be prescribed by your doctor based on your individual situation. Never take heart medications without a prescription.

When is surgery considered?

Surgery is rarely needed for palpitations. In some cases where a specific heart rhythm problem is found, a procedure called catheter ablation may be used to correct the electrical signals in the heart. This is only considered after a thorough evaluation by a heart specialist.

Living with this condition

Most people with palpitations live a completely normal life. Keep a diary of your symptoms and trigger to help you and your doctor spot patterns. If wear a heart monitor for a while, use it as directed. Learn to recognize the difference between a harmless flutter and symptoms that require emergency care.

Lifestyle tips

• Try relaxation techniques and breathing exercises daily
• Stay physically active but gradually increase intensity as allowed by your doctor
• Limit alcohol and caffeine, especially later in the day
• Avoid large heavy meals that may cause palpitations in some people
• Develop a consistent sleep routine and aim for 7–9 hours of rest per night

Diet and exercise

A balanced diet rich in vegetables, fruits, whole grains, and lean protein is good for your heart. Avoid very high doses of caffeine or sugary energy drinks. Regular moderate exercise, such as brisk walking or cycling, can strengthen your heart and reduce stress. If you feel palpitations during exercise, stop and rest, and let your doctor know.

Mental health and emotional wellbeing

Heart palpitations can be frightening, especially when they happen out of nowhere. It is normal to feel anxious about them, but worry can actually make them worse. Talk to your doctor about your fears. Cognitive behavioural therapy (CBT) and other stress-management approaches can help you cope.

Prevention

You cannot always prevent heart palpitations, especially if they are linked to a health condition. However, you can reduce their frequency by avoiding known triggers and living a heart-healthy lifestyle. Managing stress, limiting caffeine and alcohol, staying hydrated, and getting enough sleep are the most effective strategies.

Screening programmes

There is no routine screening test for palpitations in healthy people. If you have risk factors such as heart disease or a family history of rhythm problems, your doctor may recommend periodic heart check-ups.

Complications

If left untreated

• Most palpitations do not lead to complications and will not harm your heart.
• If palpitations are caused by a serious arrhythmia (abnormal heart rhythm) like atrial fibrillation, not treating it can raise the risk of blood clots, stroke, or heart failure.
• Rarely, frequent palpitations may lead to a very fast heartbeat that makes the heart beat less effectively, causing dizziness, fainting, or exhaustion.

Long-term outlook

The outlook for heart palpitations is very good. Most people have no underlying heart disease, and once triggers are identified and addressed, the palpitations often go away or become much less noticeable. Even when a heart condition is the cause, modern treatments are very effective at keeping symptoms under control and helping you live a full, active life.

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