palpitations MRI what to expect

Overview

Palpitations are feelings that your heart is pounding, fluttering, or skipping a beat. An MRI (magnetic resonance imaging) is a scan that uses strong magnets and radio waves to create detailed pictures of your heart. Your doctor may recommend an MRI if you have palpitations to check for any structural problems in your heart, such as issues with the heart muscle, valves, or blood vessels.

Yes, palpitations are extremely common. Nearly everyone feels them at some point in their life.

Anyone can experience palpitations, but they are more frequent in people with anxiety, stress, or certain heart conditions. They also occur more often in women and during pregnancy.

Symptoms

Common symptoms

• A sensation of skipped heartbeats or extra beats
• Racing or pounding heartbeat (like your heart is fluttering)
• Uncomfortable awareness of your heartbeat in your chest, throat, or neck
• Heartbeat that feels irregular or out of rhythm

Symptoms in children

• Children may describe their heart as 'fluttering' or 'jumping'
• Palpitations often occur with fever, excitement, or exercise
• They may appear as a sudden fast heartbeat that suddenly stops

Symptoms in older adults

• Palpitations may be less noticeable or described as a brief 'flip-flop' feeling
• Can be accompanied by dizziness, lightheadedness, or shortness of breath
• May signal a more serious heart rhythm problem

Causes

Main causes

• Stress, anxiety, or panic attacks
• Caffeine, alcohol, nicotine, or illegal drugs like cocaine
• Dehydration or electrolyte imbalances
• Certain medications (such as decongestants or asthma inhalers)
• Heart conditions like arrhythmias (irregular heartbeats), heart valve problems, or a weakened heart muscle

Risk factors

• High blood pressure
• Heart disease (including heart attacks or heart failure)
• Overactive thyroid (hyperthyroidism)
• Anemia (low red blood cell count)
• Pregnancy and menopause

When to see a doctor

See a doctor urgently if:

• If you have palpitations along with chest pain, fainting, or severe shortness of breath, seek emergency care
• If your palpitations are very fast (over 120 beats per minute) and don't stop

Book a routine appointment if:

• If palpitations occur several times a week or last for more than a few seconds
• If they cause you significant worry or interfere with daily life
• If you have other risk factors for heart disease

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and lifestyle. They will listen to your heart and check your pulse. If they suspect a heart problem, they may order tests to see what is happening with your heart's rhythm and structure.

Tests that may be done

• Electrocardiogram (ECG) – records your heart's electrical activity
• Holter monitor – a portable ECG you wear for 24–48 hours
• Event recorder – you activate it when you feel palpitations
• Echocardiogram – ultrasound of the heart to see its structure and movement
• Cardiac MRI – provides detailed images of the heart's chambers, valves, and muscle

What to expect at your appointment

A cardiac MRI is painless and non-invasive. You will lie on a table that slides into a tunnel-like machine. The machine makes loud knocking noises, but you will be given earplugs or headphones. You may receive an injection of contrast dye through a small IV in your arm to help make the images clearer. The scan takes 30–60 minutes, and you need to lie very still. You can talk to the technologist through a microphone. Some people feel slightly claustrophobic, but you can ask your doctor for medicine to help you relax.

Treatment

Treatment for palpitations depends on the cause. Many times no treatment is needed other than reassurance. If an underlying condition is found, the treatment will focus on that. For most people with harmless palpitations, lifestyle changes are enough.

Self-care at home

• Reduce or avoid caffeine, alcohol, and nicotine
• Manage stress and anxiety through relaxation techniques like deep breathing or meditation
• Stay well-hydrated and eat a balanced diet
• Get enough sleep and exercise regularly (after checking with your doctor)
• Keep a diary of your palpitations to share with your doctor

Medical treatments

If lifestyle changes are not enough, your doctor may recommend medications to slow down or stabilize your heart rhythm, or to treat an underlying condition like an overactive thyroid or high blood pressure. These treatments are prescribed only after a full diagnosis. Never take any medication for palpitations without a doctor's guidance.

When is surgery considered?

Surgery is rarely needed for palpitations. If a specific heart structure problem is found, such as a faulty valve or an extra electrical pathway causing very fast rhythms, procedures like catheter ablation (using heat or cold to fix the pathway) or valve repair may be considered. These are done by heart specialists.

Living with this condition

Most people with palpitations can live a full, normal life. It helps to understand that occasional palpitations are common and usually harmless. Keep a log of when they happen and what you were doing, so you can discuss patterns with your doctor.

Lifestyle tips

• Find healthy ways to cope with stress, such as exercise, hobbies, or talking to someone
• Avoid known triggers like too much caffeine or alcohol
• Do not smoke or use recreational drugs
• If you have an underlying heart condition, follow your doctor's plan carefully

Diet and exercise

Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Stay hydrated with water. Moderate exercise — like walking, swimming, or cycling — is generally safe and beneficial. Always check with your doctor before starting a new exercise program, especially if you have a known heart issue.

Mental health and emotional wellbeing

Palpitations can cause anxiety and worry, especially if they are new or frequent. It is normal to feel scared. Learning to manage stress can reduce both the palpitations and the worry. If anxiety becomes overwhelming, talk to your doctor — counseling or therapy may help.

Prevention

Not all palpitations can be prevented, but a healthy lifestyle can reduce how often they happen. Avoiding triggers and managing stress are the most effective strategies.

Screening programmes

If you have risk factors like high blood pressure or a family history of heart disease, regular check-ups with your doctor can help catch problems early. For palpitations alone, no routine screening is needed unless you have symptoms.

Complications

If left untreated

• If palpitations are caused by a serious heart rhythm disorder (like atrial fibrillation) and left untreated, they can lead to fainting, stroke, or heart failure.
• Rarely, very fast heart rhythms can cause the heart to suddenly stop (cardiac arrest).

Long-term outlook

For the vast majority of people, palpitations are harmless and go away on their own or with simple lifestyle changes. Even when a serious cause is found, modern treatments are very effective. With proper care, most people can manage palpitations well and live a long, healthy life.

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