palpitations flare ups
Informed by recognized medical guidance
Overview
Palpitations are a feeling that your heart is racing, pounding, fluttering, or skipping a beat. A flare-up means these feelings happen more often or are stronger than usual. They can feel strange, but they are often harmless. Still, it's important to know what they are and when to get medical help.
Key facts
- Most people experience palpitations at some point, and they are usually harmless.
- A flare-up can be triggered by stress, caffeine, lack of sleep, or strong emotions.
- Seek emergency help right away if palpitations come with chest pain, fainting, or severe shortness of breath.
Yes. Palpitations are very common, and flare-ups are something many people notice now and then. They are not usually a sign of a serious problem, but they can be uncomfortable and worrying.
Anyone can have palpitations, at any age. Adults get them more often than children, and they may be more noticeable during times of stress, hormonal changes, pregnancy, or as the heart ages.
Symptoms
- Chest pain, pressure, or tightness
- Fainting or passing out
- Severe difficulty breathing
- Trouble speaking or confusion
- A racing heartbeat that does not slow down after several minutes and makes you feel unwell
- ⚠Palpitations that last more than a few minutes or happen several times a day
- ⚠New or worsening dizziness, light-headedness, or fainting spells
- ⚠Swelling in your ankles or legs
- ⚠Palpitations with a fever or after a recent illness
- ⚠A known heart condition, and you notice a change in your usual rhythm
Common symptoms
- A racing or pounding heartbeat
- A fluttering sensation in the chest or throat
- Skipped or extra beats
- A feeling of a pause between heartbeats
- Pulsing in the neck or chest
- A brief feeling of unease or anxiety during an episode
Causes
Main causes
- Stress, anxiety, panic, or strong emotions
- Caffeine from coffee, tea, or energy drinks
- Alcohol or recreational drugs
- Lack of sleep or being very tired
- Medicines such as cold remedies, asthma inhalers, or some high blood pressure tablets
- Hormonal changes (pregnancy, menstruation, menopause, or thyroid problems)
- Heart conditions like an irregular heartbeat or heart valve problems
Risk factors
- High stress or anxiety levels
- Drinking large amounts of caffeine or alcohol
- Smoking or using nicotine
- High blood pressure
- Heart disease or a history of heart attacks
- Thyroid disease or anaemia
- Family history of heart rhythm problems
When to see a doctor
See a doctor urgently if:
- Seek same-day medical care if your palpitations are frequent, last a long time, or come with dizziness, shortness of breath, or mild chest discomfort.
- Also, see a doctor the same day if you have heart disease and feel a change in your heartbeat, or if you have palpitations after starting a new medicine.
Book a routine appointment if:
- Make a regular appointment if palpitations started recently, you feel them a few times a month, or you want reassurance.
- Also, schedule a check-up if you have not had heart tests before and you are worried about your pulse.
Diagnosis
Your doctor will ask about your symptoms, when they happen, how long they last, and about your general health. They may listen to your heart and check your pulse. You might be asked to keep a diary of your palpitations.
Tests that may be done
- Electrocardiogram (ECG or EKG) - a quick, painless test that records the electrical activity of your heart.
- Heart monitor (also called a Holter or event monitor) - a wearable device that records your heartbeat over 24 hours or longer to catch irregular rhythms.
- Blood tests - to check for thyroid problems, anaemia, or other causes.
- Echocardiogram - an ultrasound scan that looks at the structure and movement of your heart.
- Exercise stress test - to see how your heart behaves while you walk on a treadmill.
What to expect at your appointment
The tests are painless and usually done in a clinic that you can visit as an outpatient. Not everyone needs all of these. Your doctor will choose the tests based on your symptoms and health history. Most people go home with the results and explanation the same day or within a week.
Treatment
Treatment depends on the underlying cause of your palpitations. If they are caused by something in your everyday life, like stress or caffeine, then changing that may be enough. If a medical condition or heart rhythm issue is found, your doctor will plan care around that condition.
Self-care at home
- Reduce caffeine and avoid energy drinks.
- Limit alcohol and quit smoking if you can.
- Stay hydrated by drinking enough water.
- Aim for a regular sleep routine.
- Practice slow breathing or relaxation exercises during a flare-up.
- Keep a symptom diary to identify your personal triggers.
Medical treatments
If your doctor finds a condition that needs treatment, they may talk to you about managing anxiety, treating an overactive thyroid, or adjusting a medicine that may be causing your palpitations. For heart rhythm problems, there are medicines that help steady the heart's rhythm, but they are not suitable for everyone. Your doctor will explain your options and what is best for you. Never stop or change a medicine on your own.
When is surgery considered?
Surgery is rarely needed for palpitations. If a specific heart rhythm problem is causing them, a specialist may recommend a procedure called catheter ablation - a thin tube is used to destroy a small area of heart tissue that is causing the irregular rhythm. Another option, a pacemaker, is only used for very slow rhythms.
Living with this condition
You can live a full and active life with palpitations, especially after your doctor has checked you and explained the cause. Keep your regular routine, but know how to spot symptoms that need urgent care. Reducing stress and avoiding triggers will help keep flare-ups under control.
Lifestyle tips
- Set a regular sleep schedule and aim for 7 to 9 hours a night.
- Move your body most days - moderate activity like walking, cycling, or swimming is good for your heart and stress.
- Make time for relaxing things that calm you, like reading, listening to music, or time with people you like.
- Learn simple breathing exercises to use when you feel a flare-up starting.
- Try to avoid caffeine after midday and limit alcohol to what your doctor says is safe.
Diet and exercise
Eat a heart-healthy diet with fruits, vegetables, whole grains, and lean proteins. Keep an eye on salt if you have high blood pressure. Stay hydrated. Regular moderate exercise is encouraged, but check with your doctor before starting intense workouts, especially if you have a known heart condition.
Mental health and emotional wellbeing
Worrying about your heart can make palpitations worse. Anxiety and stress can trigger them, creating a difficult cycle. If this sounds familiar, it may help to talk to a counsellor or psychologist. They can teach you ways to ease stress and reduce the fear around your symptoms.
Prevention
You cannot always prevent palpitations, but you can prevent many flare-ups by avoiding what triggers them. The most common triggers are stress, caffeine, alcohol, poor sleep, and overexertion. Knowing your own triggers and taking care of your body can make a big difference.
Complications
If left untreated
- Most palpitations are harmless and do not lead to complications.
- If they are caused by an untreated heart rhythm disorder, there is a higher chance of developing blood clots, having a stroke, or feeling faint.
- A very rapid and chaotic heartbeat can be dangerous, but this is not the same as ordinary palpitations.
Long-term outlook
The outlook for most people with palpitations is very good. Once a doctor checks your heart and your palpitations are found to be harmless, you can live normally and comfortably. If a specific cause is found, treating it can make the palpitations improve or go away. With the right support, most people feel confident and in control.
Find support
International organisations
Local organisations
- NHS Heart Palpitations Information ↗ · United Kingdom
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.