long lasting palpitations

Overview

Long-lasting palpitations are when you feel your heart beating in your chest for a long time — it may feel like a fluttering, pounding, or racing sensation that doesn't go away quickly. It's important to check with your doctor because sometimes it can be a sign of an underlying heart problem.

Yes, many people experience palpitations at some point. Long-lasting palpitations are less common but still affect a significant number of people, especially as they get older.

Long-lasting palpitations can affect anyone, but they are more common in adults over 60, people with heart conditions, and those with anxiety or stress. They can also affect younger people, sometimes without any obvious cause.

Symptoms

Common symptoms

• A feeling that your heart is skipping a beat or fluttering
• A racing or pounding heartbeat (even when resting)
• A sensation of your heart thumping in your chest or throat
• Dizziness or lightheadedness
• Shortness of breath (mild)

Symptoms in children

• Faster heartbeat than normal for their age
• Complaints of chest discomfort or 'funny feeling'
• Fussiness or tiredness (young children may not describe it)
• Paleness or sweating

Symptoms in older adults

• Palpitations that are more noticeable when lying down
• Feeling faint or actually fainting
• Worsening of existing heart condition symptoms
• Fatigue or weakness

Causes

Main causes

• Stress, anxiety, or panic attacks
• Caffeine, alcohol, or nicotine
• Certain medications (including some cold remedies and asthma inhalers)
• Hormonal changes (such as in pregnancy or menopause)
• Electrolyte imbalances (low potassium or magnesium)
• An overactive thyroid (hyperthyroidism)
• Heart rhythm problems like atrial fibrillation or supraventricular tachycardia

Risk factors

• Being over 60 years old
• Having high blood pressure, heart disease, or heart failure
• Having an overactive thyroid or diabetes
• Excessive use of caffeine, alcohol, or stimulants
• Severe stress or anxiety disorders
• Family history of heart rhythm problems

When to see a doctor

See a doctor urgently if:

• If you have palpitations with chest pain, shortness of breath, or fainting (call emergency services)
• If palpitations are new and accompanied by dizziness or confusion

Book a routine appointment if:

• If you have persistent palpitations without emergency symptoms, see your GP within a few days
• If palpitations come back often and affect your quality of life
• If you have a history of heart disease and notice a change in your heartbeat

Diagnosis

Your doctor will ask about your symptoms, health history, and lifestyle, then listen to your heart and check your pulse. They may recommend tests to see if there is an underlying heart rhythm problem.

Tests that may be done

• Electrocardiogram (ECG) – a quick, painless test of your heart's electrical activity
• Holter monitor – a portable device you wear for 24–48 hours to record your heart rhythm
• Event monitor – a device you wear for weeks to record your heart when you have symptoms
• Blood tests – to check for thyroid problems, anemia, or electrolyte imbalances
• Echocardiogram – an ultrasound to see your heart structure

What to expect at your appointment

You may be referred to a cardiologist (heart specialist). Diagnosis usually takes a few weeks. The doctor will explain any findings and discuss treatment options if needed. You may be asked to keep a diary of your palpitations and what you were doing when they happened.

Treatment

Treatment for long-lasting palpitations depends on the cause. If it's due to an arrhythmia (irregular heartbeat), treatment may help control or stop the abnormal rhythm. Many cases are managed with lifestyle changes and monitoring alone.

Self-care at home

• Keep a symptom diary to note triggers (like caffeine, stress, alcohol)
• Reduce or avoid caffeine, alcohol, and smoking
• Practice relaxation techniques such as deep breathing or meditation
• Stay well-hydrated and get enough sleep
• Avoid overexertion if palpitations are exercise-related

Medical treatments

If palpitations are due to an arrhythmia, your doctor may prescribe medications that help control heart rate or rhythm. These are taken daily and are chosen based on your specific condition. Never stop or change medication without consulting your doctor. Other treatments may include electrical cardioversion (a controlled shock to restore normal rhythm) or catheter ablation (a procedure to destroy tiny areas of heart tissue causing the abnormal rhythm). Your doctor will explain the best option for you.

When is surgery considered?

Surgery is rarely needed. In some cases, if medication doesn't work and ablation isn't suitable, a pacemaker or implantable cardioverter-defibrillator (ICD) may be considered. Your cardiologist will discuss this if relevant.

Living with this condition

Most people with long-lasting palpitations can live normally once the cause is treated or managed. You may need to avoid specific triggers and take medication as prescribed. Regular check-ups with your doctor are important.

Lifestyle tips

• Learn stress management techniques like yoga or mindfulness
• Get regular, moderate exercise (but avoid very intense activity if palpitations occur)
• Limit stimulants like caffeine and energy drinks
• Avoid illegal drugs and excessive alcohol
• Get enough sleep each night (7–9 hours)

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Stay hydrated. Avoid very salty foods if you have high blood pressure. Gentle exercise like walking, swimming, or cycling is usually safe – start slowly and stop if palpitations worsen. Always discuss exercise plans with your doctor.

Mental health and emotional wellbeing

Palpitations can cause anxiety, and anxiety can worsen palpitations – this can become a cycle. It's common to worry about your heart. Talking to a therapist or counsellor can help. Relaxation techniques and mindfulness can reduce stress. Remember that many people manage palpitations well and lead active lives.

Prevention

Not all palpitations can be prevented, especially if they are due to a heart condition. However, a healthy lifestyle can reduce your risk: manage stress, avoid triggers, and keep blood pressure and cholesterol in check. If you have a known heart rhythm problem, following your treatment plan helps prevent episodes.

Complications

If left untreated

• If caused by atrial fibrillation, untreated palpitations increase the risk of blood clots and stroke (by five times)
• Chronic rapid heart rate can weaken the heart muscle over time (tachycardia-induced cardiomyopathy)
• Fainting (syncope) and falls leading to injury
• Heart failure if the heart pumps inefficiently for a long period

Long-term outlook

The outlook for long-lasting palpitations is often positive. Many people find that symptoms improve with treatment and lifestyle changes. Even if an underlying arrhythmia is present, modern treatments are very effective at controlling symptoms and preventing complications. With the right care, most people can continue their daily activities and enjoy a good quality of life.

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