Heart Palpitations Mostly Harmless

Overview

Heart palpitations are the feeling that your heart is beating fast, fluttering, pounding, skipping a beat, or beating harder than usual. You may notice them in your chest, throat, or neck. Most palpitations are harmless and go away on their own, but sometimes they can be a sign of another health problem. It is always okay to ask a qualified healthcare provider for advice if you are worried.

Yes. Many people notice heart palpitations at some point in their life. Most episodes are harmless and settle without treatment.

Anyone can get heart palpitations. They are more common in adults, people who are stressed or overtired, and people who use caffeine, nicotine, or alcohol. Children can get them too, but they are less often a sign of a heart problem.

Symptoms

Common symptoms

• A racing, fluttering, pounding, or skipping feeling in the chest
• Feeling your heartbeat in your throat or neck
• A sudden knowledge that your heart is beating harder than normal
• Palpitations that last a few seconds or minutes and then stop
• Feeling slightly anxious or aware of your heartbeat

Symptoms in children

• A child may say their heart is beating fast, fluttering, or pounding
• They may feel dizzy, tired, or scared
• Young children may not be able to explain the feeling clearly
• Palpitations in children are often linked to fever, dehydration, stress, or normal rhythm changes, but a doctor should check any worrying symptoms

Symptoms in older adults

• Palpitations may feel stronger or more noticeable
• They may happen with dehydration, tiredness, thyroid problems, medicine side effects, or heart conditions
• Older adults are more likely to need a check for other health problems
• Dizziness or shortness of breath with palpitations should be taken seriously

Causes

Main causes

• Stress, anxiety, or strong emotions
• Caffeine, energy drinks, alcohol, or nicotine
• Being very tired or not sleeping well
• Dehydration or low fluid levels
• Exercise or sudden physical effort
• Fever or infection
• Hormone changes, such as during pregnancy or menopause
• Anemia, which means low red blood cells
• Thyroid problems
• Some medicines or stimulants
• Heart rhythm problems or other heart conditions

Risk factors

• High stress or anxiety
• Regular use of caffeine, alcohol, or nicotine
• Poor sleep or exhaustion
• Dehydration
• A family history of heart rhythm problems
• A known heart condition
• Thyroid disease or anemia
• Pregnancy or hormone changes
• Taking medicines that can affect heart rhythm

When to see a doctor

See a doctor urgently if:

• You have palpitations with chest pain, fainting, or severe shortness of breath — call your local emergency number right away
• Palpitations are new, frequent, or lasting longer than usual
• You feel dizzy, lightheaded, or very tired with palpitations
• You have a known heart condition and palpitations change or get worse
• Palpitations start after a new medicine

Book a routine appointment if:

• Palpitations keep coming back and worry you
• You want to know whether caffeine, stress, or another trigger is involved
• Palpitations affect your sleep, work, or daily life
• You have a family history of heart rhythm problems
• You have other symptoms such as feeling shaky, sweaty, or unusually tired

Diagnosis

A healthcare provider will ask about your symptoms, your health history, and your use of caffeine, alcohol, nicotine, and medicines. They will examine you and may check your heartbeat. They may also arrange simple tests to look for common causes and to check your heart rhythm.

Tests that may be done

• Electrocardiogram, also called an ECG or EKG, which records the heart's electrical activity
• Blood tests to check for anemia, thyroid problems, and other causes
• A heart monitor worn for a day or longer if palpitations come and go
• An event recorder or smart device check if symptoms happen only now and then
• An ultrasound of the heart, called an echocardiogram, if a heart problem is suspected
• A check of your medicines and stimulant use

What to expect at your appointment

Many people have normal test results. That is common and can be reassuring. If a cause is found, your provider will explain your options. If tests are normal, you may still be given advice about triggers and when to come back.

Treatment

Treatment depends on the cause and on how much the palpitations affect you. Most harmless palpitations do not need medicine. Your healthcare provider may focus on avoiding triggers, treating another condition, or checking your heart rhythm. Always ask a qualified healthcare provider before making changes to your medicines.

Self-care at home

• Cut back on caffeine, energy drinks, alcohol, and nicotine
• Drink enough water, especially in hot weather or during exercise
• Try to get regular sleep and rest
• Use calm breathing or relaxation techniques when you feel stressed
• Notice and write down what seems to trigger your palpitations
• Avoid taking stimulant supplements unless your provider says they are safe for you

Medical treatments

If a cause is found, your provider may treat that condition — for example, thyroid problems, anemia, or dehydration. Sometimes a medicine that helps control heart rate or rhythm may be recommended by a heart specialist. Your provider may also review your current medicines to see if one could be contributing. No specific medicine is right for everyone, so this should be decided with a qualified healthcare provider.

When is surgery considered?

Surgery is not common for harmless palpitations. Rarely, if a specific heart rhythm problem is found and other treatments do not work, a heart specialist may discuss a procedure such as catheter ablation. This would only be considered after a full assessment.

Living with this condition

Most people can live normally with harmless palpitations. It can help to keep a simple diary of when they happen, how long they last, and what you were doing at the time. This can make you feel more in control and gives your provider useful information.

Lifestyle tips

• Keep a regular sleep routine
• Stay physically active in a way that suits you
• Limit caffeine and alcohol
• Do not smoke or use nicotine products
• Drink water throughout the day
• Manage stress with gentle exercise, breathing exercises, or hobbies
• Avoid over-the-counter stimulants unless your pharmacist or provider says they are safe for you

Diet and exercise

A balanced diet and regular gentle exercise are good for heart health. Some people find that large meals, very cold drinks, or too much caffeine trigger palpitations. Exercise is usually safe if you feel well, but if palpitations happen during exercise or you have a known heart condition, ask your healthcare provider what is right for you.

Mental health and emotional wellbeing

Palpitations can make people feel anxious, and anxiety can make palpitations more noticeable. This can become a cycle. Learning relaxation skills and talking about your worries can help. If you ever feel overwhelmed or have thoughts of harming yourself, contact your local emergency number or a local crisis support service right away.

Prevention

Not all palpitations can be prevented, but many common triggers can be reduced. Cutting back on caffeine, alcohol, and nicotine, staying hydrated, sleeping well, and managing stress may help. If you have a health condition that causes palpitations, treating it can lower your chance of symptoms.

Vaccines

There is no vaccine for heart palpitations. Staying up to date with routine vaccines recommended for your age and health is still important, because infections and fever can sometimes trigger a fast heartbeat.

Screening programmes

There is no routine screening for harmless palpitations. If you have a heart condition or a strong family history of heart rhythm problems, your healthcare provider may arrange checks.

Complications

If left untreated

• Most harmless palpitations do not cause complications
• If an underlying condition such as anemia or thyroid disease is not treated, symptoms may continue
• Rarely, some heart rhythm problems can lead to dizziness, fainting, or more serious heart issues if ignored
• Untreated anxiety can make palpitations feel worse and affect sleep and daily life

Long-term outlook

The outlook is usually very good. Most palpitations are harmless and settle with simple changes or reassurance. If a cause is found, many conditions can be treated or managed well. See a qualified healthcare provider if you are worried, and seek emergency help for severe symptoms.

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