palpitations risk reduction

Overview

Palpitations are a feeling that your heart is pounding, racing, fluttering, or skipping a beat. Many people describe it as a 'flip-flop' in their chest. They can be harmless, but they can also be a sign of a heart rhythm problem. Reducing your risk means learning what can trigger them and looking after your overall heart health.

Yes. Palpitations are very common. Most people experience them at some point, and they are one of the most frequent reasons people visit their GP.

Palpitations can happen at any age, in both men and women. They may be more noticeable during pregnancy, after exercise, or during times of stress. People with anxiety, anaemia, thyroid problems, or heart conditions may be more likely to notice them.

Symptoms

Common symptoms

• A racing heartbeat
• Fluttering in your chest
• A missed or skipped beat
• Pounding in your neck
• A feeling that your heart pauses
• An uncomfortable awareness of your heartbeat

Causes

Main causes

• Stress, anxiety, fear, or panic attacks
• Strenuous exercise
• Caffeine, energy drinks, or some cold and allergy medicines
• Alcohol or nicotine (smoking)
• Lack of sleep or dehydration
• Hormone changes such as pregnancy or menopause
• Thyroid problems, anaemia, low blood pressure, or fever
• Heart conditions such as atrial fibrillation or other arrhythmias

Risk factors

• High stress or anxiety
• Drinking too much alcohol or caffeine
• Some stimulant medicines or recreational drugs
• Having heart disease, high blood pressure, or diabetes
• Pregnancy
• Electrolyte imbalances (low potassium or magnesium)
• Strong emotions such as fear or excitement

When to see a doctor

See a doctor urgently if:

• Palpitations that happen often or last for more than a few minutes
• Palpitations that make you feel very tired or breathless
• Palpitations that wake you from sleep
• Palpitations along with a rapid pulse that does not settle

Book a routine appointment if:

• If you have never had palpitations before and they happen a few times
• If you notice palpitations when you change position or after eating
• If you are worried about palpitations and want reassurance or a heart check

Diagnosis

Your doctor will ask about when your palpitations happen, how long they last, and what you were doing. They will listen to your heart and check your pulse. If needed, they may refer you to a heart specialist for rhythm monitoring.

Tests that may be done

• Electrocardiogram (ECG) – a painless recording of your heart's electrical activity
• Holter monitor or event recorder – a small device you wear to track your heart rhythm over days or weeks
• Blood tests – to check your thyroid, blood count, and salt/mineral levels
• Echocardiogram – an ultrasound of your heart to see its structure and function

What to expect at your appointment

You will not usually need a long stay in hospital. Some tests take minutes; others involve wearing a small monitor for a few days. Your doctor will explain what they find and whether you need treatment or just reassurance and lifestyle changes.

Treatment

Treatment for palpitations depends on the cause. If you have a normal heart and no underlying condition, you may not need any specific medical treatment. The main steps are to reduce triggers and look after your general health. If a heart rhythm problem is found, your doctor will discuss options such as medication, a procedure, or a device to keep your heart rhythm stable.

Self-care at home

• Keep a diary of when palpitations happen and what you were doing, eating, or feeling
• Limit caffeine and alcohol
• Avoid smoking and recreational drugs
• Make sure you get enough sleep and stay well hydrated
• Learn simple breathing or relaxation exercises to manage stress

Medical treatments

Medical treatment is tailored to the cause. Depending on the diagnosis, a heart specialist may prescribe medicine to control your heart rhythm or slow your heart rate. Other approaches include cardioversion (an electrical shock to reset the rhythm), catheter ablation (a procedure to destroy tiny areas of heart tissue causing abnormal rhythms), or a pacemaker if your heart rate is too slow. Your doctor will explain the best option for you.

When is surgery considered?

Surgery is rarely needed for palpitations alone. It may be considered if you have an underlying heart problem, such as severe valve disease or coronary artery blockages, that is causing the rhythm disturbance.

Living with this condition

If your palpitations are harmless, you can live a normal, active life. Learn what triggers your own palpitations and try to avoid them. If they happen, stop, sit down, and take slow deep breaths. Knowing what to do can help you feel in control.

Lifestyle tips

• Get regular physical activity
• Sleep 7–9 hours per night if you can
• Limit alcohol and caffeine
• Eat a balanced diet rich in fruits, vegetables, and whole grains
• Practice relaxation techniques like breathing exercises or mindfulness

Diet and exercise

Aim for a heart-healthy diet with plenty of vegetables, fruits, whole grains, and lean protein. Try to do at least 150 minutes of moderate exercise per week, such as brisk walking. If exercise triggers palpitations, talk to your doctor before increasing your activity level.

Mental health and emotional wellbeing

Palpitations can cause anxiety, and anxiety can make palpitations feel worse. It is a cycle. It is normal to worry about your heart. If you feel anxious about your palpitations, speak to your doctor. Breath training, counselling, or talking therapy can help break the cycle.

Prevention

You can reduce your risk of palpitations by following a heart-healthy lifestyle. Identify your personal triggers and take steps to avoid them. Not all palpitations can be prevented, especially if you have a heart condition, but many are related to lifestyle and stress.

Vaccines

Stay up to date with recommended vaccines, such as the flu vaccine, especially if you have heart disease. Infections can sometimes trigger palpitations or make an irregular heart rhythm worse.

Screening programmes

Tell your doctor if you have high blood pressure, diabetes, or a family history of heart rhythm problems. There is no routine screening test for palpitations, but your doctor may recommend an ECG or heart check if you are at higher risk.

Complications

If left untreated

• If an abnormal rhythm is left untreated, it may lead to poor blood circulation
• It can increase the risk of blood clots, which may cause a stroke
• In rare cases, an untreated rhythm problem can weaken the heart muscle over time

Long-term outlook

The outlook for palpitations is generally very good. For most people, they are harmless and come and go without causing any damage. If you do have an underlying rhythm problem, treatments are very effective. Most people are able to manage their symptoms and live full, active lives.

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