Palpitations what it can mean

Overview

Palpitations are the sensation of feeling your own heart beat. It may feel like your heart is pounding, fluttering, racing, or skipping a beat. Most of the time, palpitations are harmless and go away on their own, but they can sometimes be a sign of a heart condition that needs attention.

Yes, palpitations are extremely common. Most people experience them at some point in their lives.

Palpitations can affect anyone, but they are more common in people who are anxious, consume stimulants like caffeine or nicotine, have anemia or thyroid problems, or have a family history of heart rhythm issues.

Symptoms

Common symptoms

• A feeling that your heart is racing or pounding
• A fluttering sensation in your chest
• A pause or a skipped beat
• Beating too hard or too fast

Symptoms in children

• Children may complain of a fast or pounding heartbeat
• They might feel dizzy or have chest discomfort
• Sometimes they describe it as their heart 'flip-flopping'

Symptoms in older adults

• Older adults may experience palpitations along with shortness of breath
• Fatigue or lightheadedness is common
• Palpitations may be more noticeable when resting

Causes

Main causes

• Stress or anxiety
• Caffeine (coffee, tea, energy drinks)
• Nicotine (smoking or vaping)
• Alcohol
• Certain medications (like decongestants or asthma inhalers)
• Lack of sleep
• Dehydration
• Heart rhythm disorders (arrhythmias)
• Overactive thyroid (hyperthyroidism)
• Anemia

Risk factors

• Anxiety or panic disorders
• High blood pressure
• Heart disease (including previous heart attack or heart failure)
• Pregnancy
• Use of stimulants (caffeine, nicotine, illegal drugs)
• Electrolyte imbalances (low potassium, magnesium)
• Family history of heart rhythm problems

When to see a doctor

See a doctor urgently if:

• If palpitations start suddenly and you also have chest pain, fainting, or trouble breathing – call your local emergency number.
• If palpitations are new and worry you, especially if you have a known heart condition.

Book a routine appointment if:

• If palpitations happen often or bother you, even without other symptoms.
• If they interfere with your daily life or sleep.
• If you have risk factors like heart disease or a family history of arrhythmias.

Diagnosis

Your doctor will ask about your symptoms, when they happen, and your medical history. They will listen to your heart and may order tests to see if your heart rhythm is normal.

Tests that may be done

• Electrocardiogram (ECG or EKG) – a quick test that records the electrical activity of your heart.
• Holter monitor – a portable ECG you wear for 24 to 48 hours to capture occasional palpitations.
• Event recorder – a device you wear for weeks to record your heart rhythm when you push a button during symptoms.
• Blood tests – to check for anemia, thyroid problems, or electrolyte imbalances.
• Echocardiogram – an ultrasound of your heart to see its structure and function.

What to expect at your appointment

Your doctor will work to find the cause of your palpitations. You may be asked to keep a diary of when they occur, what you were doing, and how long they lasted. Most tests are painless and done in the clinic. If the results are normal, that is reassuring.

Treatment

Treatment depends on the cause. Many palpitations do not need any treatment. If a lifestyle factor is to blame, making changes may stop them. If a heart rhythm problem is found, your doctor may suggest medication or a procedure. Always follow your doctor’s advice.

Self-care at home

• Cut back on caffeine, alcohol, and nicotine.
• Practice relaxation techniques like deep breathing or meditation.
• Get enough sleep and stay well hydrated.
• Avoid stimulants in cold medicines or energy drinks.
• Keep a diary of your palpitations to identify triggers.

Medical treatments

If palpitations are caused by an arrhythmia, your doctor may prescribe medications to control your heart rate or rhythm. These are called antiarrhythmic drugs. In some cases, a procedure called catheter ablation may be recommended to correct abnormal electrical pathways in the heart. Always discuss the benefits and risks with your healthcare provider. You should not stop or start any medication without your doctor’s guidance.

When is surgery considered?

Surgery is rarely needed for palpitations. However, for certain arrhythmias that do not respond to medication, a minimally invasive procedure like catheter ablation or, very rarely, implanting a pacemaker may be considered. Your heart specialist will explain if this is an option for you.

Living with this condition

Most people with harmless palpitations can live a normal life. It helps to know your triggers and avoid them. If you have a diagnosed heart rhythm condition, follow your treatment plan and attend regular check-ups.

Lifestyle tips

• Practice stress management – try yoga, meditation, or talking to a counsellor.
• Limit caffeine, alcohol, and tobacco.
• Stay active with moderate exercise, but avoid overexertion if it triggers symptoms.
• Get 7-9 hours of sleep each night.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Limit stimulants like caffeine and energy drinks. Regular moderate exercise is good for heart health. If exercise triggers your palpitations, talk to your doctor before continuing.

Mental health and emotional wellbeing

Palpitations can cause worry or anxiety, which can actually make them worse. It is important to address any fear you have. If anxiety is a big part of your symptoms, speaking with a mental health professional can help break the cycle.

Prevention

Not all palpitations can be prevented, but you can reduce how often they happen by avoiding known triggers like too much caffeine, stress, and lack of sleep. Staying hydrated and managing chronic conditions like high blood pressure or thyroid disease also helps.

Complications

If left untreated

• For harmless palpitations – no complications.
• If due to a serious arrhythmia – untreated could lead to fainting (syncope), stroke, or heart failure.
• Rarely, certain arrhythmias can cause cardiac arrest if not treated.

Long-term outlook

For the vast majority of people, palpitations are not a sign of a dangerous condition and go away on their own or with simple lifestyle changes. Even when a heart rhythm problem is found, treatments are very effective and most people manage well with medication or a procedure. The outlook is generally excellent.

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