screening for palpitations

Overview

Palpitations are the feeling that your heart is racing, fluttering, skipping a beat, or beating too hard. Screening for palpitations means checking what is causing these sensations. For most people, palpitations are harmless, but sometimes they can point to a heart rhythm problem that needs treatment.

Yes. Most people experience palpitations at some point in their lives. They are one of the most common reasons people visit a heart doctor.

Palpitations can affect anyone, but you are more likely to have them during pregnancy, after stressful events, or if you have an overactive thyroid, anaemia, or a heart condition. Older adults may also have palpitations because of changes in the heart’s electrical system.

Symptoms

Common symptoms

• A racing heartbeat
• A fluttering sensation in the chest
• Feeling like your heart skipped a beat
• Pounding in the neck or chest
• A brief feeling that the heart stopped for a moment

Symptoms in children

• Children may describe their heart as “jumping” or “fluttering”.
• They might seem unusually tired or less active.
• Some children feel dizzy or have mild chest discomfort.

Symptoms in older adults

• Palpitations may feel less noticeable but last longer.
• Dizziness or light-headedness is more common.
• Older adults may also experience shortness of breath or mild confusion during episodes.

Causes

Main causes

• Stress, anxiety, or panic
• Caffeine, alcohol, or energy drinks
• Not enough sleep
• Certain medicines, including some cold and asthma treatments
• Anaemia (low red blood cells)
• Overactive thyroid
• Changes in blood pressure or blood sugar
• Heart conditions, such as an irregular heartbeat or heart valve problems

Risk factors

• Existing heart disease or a history of heart attack
• High blood pressure
• Electrolyte imbalances (low potassium or magnesium)
• Pregnancy
• Being very overweight
• Heavy or binge drinking of alcohol
• Using stimulant drugs such as cocaine or methamphetamine

When to see a doctor

See a doctor urgently if:

• If your palpitations happen with chest pain, fainting, or severe breathlessness, call your local emergency number right away.
• If you have a heart condition like heart failure or have had a heart attack and notice new palpitations, seek urgent medical help.

Book a routine appointment if:

• If you have palpitations that are new, keep happening, or worry you, book an appointment with your doctor.
• If you also feel tired, dizzy, or short of breath, mention this to your doctor.
• If you are pregnant and have frequent palpitations, discuss them with your maternity care team.

Diagnosis

To screen for palpitations, your doctor will first talk to you about your symptoms, your medical history, and any medicines you take. They will check your pulse, listen to your heart, and may order tests to see the heart’s electrical activity.

Tests that may be done

• Electrocardiogram (ECG) – a quick, painless test that records the heart’s rhythm
• Ambulatory ECG – you wear a small monitor for 24 to 48 hours at home to catch irregular heartbeats
• Event recorder – you press a button to record your heart when you feel palpitations
• Blood tests – to check thyroid hormone, iron, and electrolyte levels
• Echocardiogram – an ultrasound scan to look at the heart’s structure and function

What to expect at your appointment

Most screening tests are simple and painless. You may need to wear a monitor for a few days. Your doctor will explain what each test looks for and what the results mean. If no serious cause is found, that is good news. If a problem is found, there are many safe and effective ways to manage it.

Treatment

Treatment for palpitations depends on the cause. If the cause is stress, caffeine, or a medicine you are taking, small changes may be enough. If a heart rhythm problem is found, your doctor may suggest medicines, procedures, or lifestyle changes to help your heart stay in a steady rhythm.

Self-care at home

• Keep a diary of when palpitations happen – note what you were doing, eating, or feeling.
• Reduce or avoid caffeine, energy drinks, and alcohol.
• Practice slow, calm breathing when you feel stressed.
• Make sure you get enough sleep and stay hydrated.
• Stop smoking and avoid recreational drugs.

Medical treatments

Doctors may prescribe medicines to slow a fast heartbeat or to keep the rhythm steady. They might also recommend procedures such as electrical cardioversion (a controlled shock to reset the heart rhythm) or catheter ablation (a small procedure to fix the part of the heart causing the irregular beat). Which approach is safest depends on your specific situation, so your doctor will discuss all options with you.

When is surgery considered?

Surgery is rarely the first treatment for palpitations. In certain cases, procedures like catheter ablation are used, and some people with a very slow heartbeat may need a pacemaker. Your heart team will only suggest surgery if tests show it is the best option for you.

Living with this condition

If you have palpitations, try to learn what triggers them and avoid those triggers where possible. Keep your regular appointments so your doctor can check how you are doing, and carry a list of your medicines with you in case you go to a hospital.

Lifestyle tips

• Aim for 7–9 hours of sleep each night.
• Limit caffeine to small amounts, or cut it out entirely.
• Manage stress with breathing exercises, walking, or mindfulness.
• Avoid drinking more than small amounts of alcohol.
• Stay active, but check with your doctor before starting intense exercise.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. Make sure you get enough potassium and magnesium through foods like bananas, leafy greens, nuts, and beans. Gentle to moderate exercise, such as walking or swimming, is usually safe and good for your heart. If exercise brings on palpitations, tell your doctor.

Mental health and emotional wellbeing

Palpitations can be frightening and may cause anxiety, which in turn can make palpitations worse. This is a normal cycle, but you do not have to manage it alone. Speak to your doctor if you feel anxious about your heart or if the constant worry affects your daily life. They can offer support or suggest resources to help you cope.

Prevention

It is not always possible to prevent palpitations, especially if you have an underlying heart condition. However, a heart-healthy lifestyle can reduce how often they happen and lower your risk of heart rhythm problems.

Vaccines

Stay up to date with recommended vaccinations, including flu and other vaccines your doctor suggests. Preventing infections that can stress the heart may also help prevent palpitations that are triggered by illness.

Screening programmes

There is no routine screening test for palpitations in people without symptoms. If you have risk factors for heart disease, your doctor may recommend a heart check-up that includes an ECG and blood pressure measurement.

Complications

If left untreated

• If palpitations are caused by a serious irregular heartbeat and are not treated, they may increase the risk of stroke.
• Very fast heart rhythms can reduce blood flow to the body and cause heart failure over time.
• Frequent palpitations can lead to dizziness, falls, or fainting.
• In rare cases, an untreated dangerous rhythm can cause cardiac arrest.

Long-term outlook

The outlook for people with palpitations is generally very good. Most people do not have a serious problem, and even those who do can be helped with modern treatments. If your doctor finds the cause and you follow their advice, you can live a full and active life.

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