palpitations treatment options overview

Overview

Palpitations are the feeling that your heart is racing, fluttering, or skipping a beat. You may feel this in your chest, throat, or neck. They are usually harmless, but sometimes they can be a sign of a heart problem.

Yes, palpitations are very common. Almost everyone feels them at some point. Most of the time they are brief and go away on their own.

Palpitations can affect people of all ages. They are more likely in people who are anxious, under stress, pregnant, or who have certain heart conditions.

Symptoms

Common symptoms

• Racing heartbeat
• Fluttering or thumping in the chest
• Heart skipping a beat
• Pounding feeling in the neck or throat
• Feeling your heartbeat irregularly

Symptoms in children

• Children may describe their heart as 'jumping' or 'going really fast'.
• They may feel tired, dizzy, or have belly pain with palpitations.
• Tell your child's doctor if they mention these feelings often.

Symptoms in older adults

• Older adults may feel palpitations along with lightheadedness or tiredness.
• They may be more likely to have an underlying heart condition.
• If palpitations are new or happen often, a doctor should check them.

Causes

Main causes

• Stress, anxiety, or panic
• Caffeine, alcohol, or nicotine
• Exercise or physical exertion
• Fever, dehydration, or lack of sleep
• Hormone changes, such as pregnancy or menopause
• Overactive thyroid or anemia
• Heart rhythm problems like atrial fibrillation
• Some cold, asthma, or weight-loss medicines

Risk factors

• High stress or anxiety
• Drinking a lot of caffeine or energy drinks
• Heavy alcohol use
• Heart disease, high blood pressure, or history of heart attack
• When you are pregnant
• Taking certain medicines that can affect your heart rhythm

When to see a doctor

See a doctor urgently if:

• If you have palpitations with chest pain, shortness of breath, fainting, or severe dizziness, call your local emergency number right away.
• If you have palpitations often, they last longer than a few minutes, or they come with weakness, seek same-day medical care.

Book a routine appointment if:

• Make a routine appointment if you notice palpitations occasionally and they bother you.
• See your doctor if you have risk factors for heart disease, like high blood pressure or high cholesterol, and you start feeling palpitations.

Diagnosis

Your doctor will ask about your symptoms, check your pulse, and listen to your heart. They may want to know what you were doing when the palpitations happened and whether you had other symptoms.

Tests that may be done

• Electrocardiogram (ECG or EKG) — a quick, painless test that records your heart's electrical activity
• Holter monitor — you wear a small device for 24 to 48 hours to track your heart continuously
• Event recorder — you push a button when you feel palpitations to record your heart at that moment
• Blood tests — to check for thyroid problems, anemia, or electrolyte imbalances

What to expect at your appointment

Most people do not need many tests. If your doctor finds a possible heart rhythm problem, they may refer you to a heart specialist. The tests are usually painless and can be done during an outpatient visit.

Treatment

Treatment for palpitations depends on the cause. If they are linked to stress, caffeine, or other triggers, you may only need to make lifestyle changes. If an underlying health condition is causing them, treating that condition often stops the palpitations. For serious rhythm problems, doctors have several safe and effective options.

Self-care at home

• Reduce caffeine, energy drinks, and alcohol.
• Try slow, deep breathing when you feel stressed or anxious.
• Get enough sleep and stay hydrated.
• Avoid smoking and nicotine products.
• If you notice a trigger, try to avoid it or manage your reaction to it.

Medical treatments

If the palpitations are due to a heart rhythm problem, a doctor may recommend medicines to help steady the heart's rhythm or slow a fast heartbeat. These are only prescribed after a full evaluation. Sometimes a doctor may suggest a procedure such as catheter ablation, which uses heat or cold to fix a small part of the heart that causes abnormal rhythms. All treatments are tailored to your specific condition and your doctor will explain the risks and benefits before you decide.

When is surgery considered?

A procedure like catheter ablation is not surgery in the usual sense, but it is a minimally invasive treatment for certain rhythm problems. It is only considered when medicines do not work or when you have a specific rhythm problem that ablation can fix.

Living with this condition

For many people, palpitations are just an occasional nuisance. Keeping track of when they happen and what you were doing can help you and your doctor understand them. Always tell your doctor if you notice changes in how often they occur or if new symptoms appear.

Lifestyle tips

• Manage stress with relaxation techniques, yoga, or meditation.
• Limit caffeinated drinks like coffee, tea, and cola.
• Cut back on alcohol and avoid binge drinking.
• Stop smoking and avoid recreational drugs.
• Stay physically active in ways you enjoy, but check with your doctor if you have heart disease.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Stay hydrated. Regular, moderate exercise like walking or swimming is good for your heart. If you have a heart condition, ask your doctor which activities are safe for you.

Mental health and emotional wellbeing

Palpitations can be scary, especially if you don't know what is causing them. Anxiety can make them worse, creating a cycle. It is important to address stress and anxiety with your doctor or a counsellor. A calm mind often means a calmer heart.

Prevention

You cannot always prevent palpitations, but you can reduce your risk by avoiding known triggers. Eating well, exercising, managing stress, and limiting caffeine and alcohol are good steps. If you have high blood pressure or another heart condition, keeping it under control also helps.

Screening programmes

There is no routine screening test for palpitations in healthy people. However, a regular check-up with your doctor can help catch conditions that might lead to palpitations, such as high blood pressure or an overactive thyroid.

Complications

If left untreated

• Most palpitations are harmless and go away on their own.
• If palpitations come from a serious heart rhythm problem and are not treated, they could lead to fainting, stroke, or heart failure.
• Very rarely, an untreated rhythm problem can cause the heart to stop beating (cardiac arrest).

Long-term outlook

The outlook is very good for most people with palpitations. Once your doctor checks your heart and rules out serious problems, you can usually feel confident that palpitations are not dangerous. If there is an underlying cause, treatment can help you feel back to normal. You can live a full, active life.

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