Living with palpitations

Overview

Palpitations are the feeling that your heart is racing, fluttering, pounding, or skipping a beat. You may feel this in your chest, throat, or neck. They are common and usually not a sign of something serious, but they can sometimes be caused by an underlying heart condition.

Yes. Almost everyone experiences palpitations at some point in their life. For most people, they are annoying but not dangerous.

Palpitations can affect people of all ages, genders, and backgrounds. They are more likely to happen during times of stress, anxiety, or hormonal changes, and in people who have existing heart conditions.

Symptoms

Common symptoms

• A racing heartbeat
• A fluttering or pounding feeling in your chest
• Feeling that your heart has skipped a beat
• A sensation that your heart is beating out of rhythm
• Feeling your pulse in your neck or throat

Symptoms in children

• Children may describe the same fluttering or racing feeling in their chest.
• They may appear anxious or fussy.
• Sometimes they may say their chest feels 'funny' or that their heart is 'jumping'.

Symptoms in older adults

• Palpitations may come with shortness of breath, fatigue, or dizziness.
• They are more likely to be linked to an underlying heart condition, so a medical check is especially important.
• Fainting or feeling lightheaded is a warning sign that needs urgent attention.

Causes

Main causes

• Stress, anxiety, or a panic attack
• Too much caffeine from coffee, tea, or energy drinks
• Alcohol or recreational drugs
• Nicotine from smoking or vaping
• Physical exercise or strenuous activity
• Dehydration or low blood sugar
• Hormone changes, such as during pregnancy, menstruation, or menopause
• Fever or infection
• Certain prescription or over-the-counter medicines
• Underlying heart rhythm problems or thyroid conditions

Risk factors

• High levels of stress or anxiety
• Lack of sleep or poor sleep quality
• Heavy caffeine or alcohol use
• Smoking or vaping
• Pregnancy
• A history of heart disease or arrhythmias
• Electrolyte imbalances, such as low potassium or magnesium
• Being very overweight

When to see a doctor

See a doctor urgently if:

• If you have heart disease, high blood pressure, or a history of stroke, and you start having palpitations
• If palpitations happen with fainting, chest pain, or severe breathlessness
• If palpitations are very frequent, last a long time, or keep coming back

Book a routine appointment if:

• If palpitations bother you or worry you, even if they are not painful
• If you notice a clear pattern, such as happening every day after coffee
• Before starting a new exercise program if you have palpitations or a heart condition

Diagnosis

A doctor will start by asking about your symptoms, what triggers them, your medical history, and your lifestyle. They may listen to your heart and check your pulse.

Tests that may be done

• Electrocardiogram (ECG) – a quick test that records your heart's electrical activity.
• Holter monitor – you wear a small device for 24 to 48 hours that records your heart continuously.
• Event monitor – you wear this longer and press a button when you feel palpitations.
• Blood tests – to check for thyroid problems, electrolyte imbalances, or other health issues.
• Echocardiogram – an ultrasound of the heart to check its structure and function.

What to expect at your appointment

Your doctor may ask you to keep a diary of your palpitations, noting when they happen, what you were doing, and how you felt. This helps identify triggers. If the initial tests are normal, you may not need further tests. If a rhythm problem is found, you may be referred to a heart specialist.

Treatment

Treatment for palpitations depends on the cause. If lifestyle triggers are responsible, avoiding them may be all you need. If an underlying heart condition or medical problem is found, treating that condition often helps stop the palpitations. Many people need no specific treatment at all.

Self-care at home

• Cut back on caffeine, especially coffee, tea, and energy drinks
• Limit or avoid alcohol and quit smoking or vaping
• Manage stress with breathing exercises, meditation, or gentle activity
• Drink enough water to stay well hydrated
• Get enough sleep and try to keep a regular sleep schedule
• Keep a diary to help identify your personal triggers

Medical treatments

If palpitations are caused by a specific heart rhythm problem, a doctor may offer treatment to control the heart rhythm or rate. Medicines are prescribed only after a full evaluation and are always tailored to the individual. You should never take any heart medicine without a doctor's advice, as the wrong treatment can be harmful.

When is surgery considered?

Very rarely, a procedure called catheter ablation may be recommended to correct a specific electrical problem in the heart. This is only considered when palpitations are frequent, troublesome, or linked to a serious rhythm disorder.

Living with this condition

For most people, palpitations are not dangerous and can be managed by avoiding triggers and living a healthy lifestyle. It can help to remind yourself that a brief fluttering feeling is rarely a sign of a problem. Try to stay calm during a palpitation episode – taking slow, deep breaths can help.

Lifestyle tips

• Practice relaxation techniques such as deep breathing, mindfulness, or yoga
• Limit caffeine and energy drinks
• Avoid heavy alcohol intake
• Stay physically active with activities you enjoy, as your doctor advises
• Maintain a healthy weight
• Talk to friends, family, or a support group if anxiety is affecting you

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains helps keep your heart healthy. Limit salt and processed foods. Stay hydrated. Regular, moderate exercise is generally safe and beneficial for most people with palpitations, but it is wise to check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Palpitations can make you feel worried or anxious, especially if you do not know the cause. Anxiety itself can also trigger palpitations, creating a cycle. If you feel anxious or stressed about your heart, speak to your doctor or a mental health professional. They can help you manage these feelings.

Prevention

Not all palpitations can be prevented, especially if they are related to a medical condition. However, many palpitations are triggered by lifestyle factors, and you can reduce them by managing stress, limiting caffeine and alcohol, staying hydrated, and getting regular, good-quality sleep.

Vaccines

There is no specific vaccine for palpitations. However, staying up to date with recommended vaccines prevents infections that could stress the heart and potentially contribute to palpitations.

Screening programmes

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

Complications

If left untreated

• If palpitations come from a serious heart rhythm problem and are left untreated, they can lead to fainting, falls, or injuries.
• Some rhythm problems, if ongoing, can increase the risk of stroke or affect how well the heart pumps blood.
• Palpitations caused by an overactive thyroid or other treatable condition may worsen if the underlying issue is not addressed.

Long-term outlook

The outlook for people with palpitations is usually very good. Most people do not need treatment, and palpitations often become less frequent once triggers are identified and avoided. For those with an underlying cause, treatment is effective in many cases. With the right support and check-ups, most people continue to live full and active lives.

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