When to seek care for palpitations

Overview

Palpitations are the feeling that your heart is beating too fast, skipping a beat, or fluttering. It’s a common sensation that can feel alarming but is often harmless.

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

Palpitations can affect people of any age, including children and older adults. They are slightly more common in people with anxiety or heart conditions.

Symptoms

Common symptoms

• A racing or pounding heartbeat
• A feeling of skipped heartbeats or fluttering in the chest
• A sensation of your heart beating in your neck or throat

Symptoms in children

• Children may say their heart is 'jumping' or 'racing'
• They might feel dizzy or short of breath during episodes
• Palpitations in children are usually harmless but should be checked by a doctor

Symptoms in older adults

• Palpitations may be felt along with dizziness or lightheadedness
• Shortness of breath or fatigue may be more noticeable
• Older adults should always have new or worsening palpitations evaluated, as they can be linked to heart disease

Causes

Main causes

• Stress, anxiety, or panic attacks
• Caffeine, alcohol, nicotine, or recreational drugs
• Thyroid problems (overactive thyroid)
• Anemia (low red blood cells)
• Hormonal changes (pregnancy, menopause)
• Heart rhythm disorders (like atrial fibrillation)

Risk factors

• High levels of stress or anxiety
• Excessive consumption of caffeine or alcohol
• Certain medications (like cold medicines or asthma inhalers)
• Underlying heart conditions
• Electrolyte imbalances (low potassium or magnesium)

When to see a doctor

See a doctor urgently if:

• If you have palpitations together with chest pain, fainting, or severe shortness of breath, call your local emergency number immediately.
• Seek same-day care if you feel very dizzy or have a history of heart disease with new palpitations.

Book a routine appointment if:

• If palpitations happen often, last a long time, or worry you.
• If you have other symptoms like tiredness, weight loss, or trouble breathing.
• If palpitations started after starting a new medicine.

Diagnosis

Your doctor will ask about your symptoms, medical history, and any triggers. They will check your pulse, listen to your heart, and may order tests to look for underlying causes.

Tests that may be done

• Electrocardiogram (ECG) – a quick test that records your heart’s rhythm
• Holter monitor – a portable ECG worn for 24 to 48 hours
• Event recorder – a device you use for weeks or months to record palpitations when they happen
• Blood tests – to check for thyroid problems, anemia, or electrolyte imbalances
• Echocardiogram – an ultrasound of your heart to check its structure and function

What to expect at your appointment

Most tests are painless and done in a clinic or hospital. Your doctor will explain the results and whether any further action is needed. You may be asked to keep a diary of your symptoms.

Treatment

Treatment depends on the cause. If palpitations are due to a harmless cause, no treatment is needed. If they are linked to another condition or a heart rhythm problem, the underlying cause is treated.

Self-care at home

• Reduce or avoid caffeine, alcohol, and nicotine
• Practice stress management techniques like deep breathing or meditation
• Stay hydrated and get enough sleep
• Keep a symptom diary to identify triggers

Medical treatments

If palpitations are caused by a heart rhythm disorder, your doctor may recommend medications that help control the heart rate or rhythm. These are prescribed only after a full evaluation. Never take any medication for palpitations without a doctor’s advice.

When is surgery considered?

In some cases, a procedure called catheter ablation may be used to treat certain heart rhythm problems. This is only considered after other treatments have been tried or if the condition is serious.

Living with this condition

Learn what triggers your palpitations and try to avoid those triggers. Keep a simple diary noting when they happen, how you feel, and what you were doing. This helps you and your doctor manage them.

Lifestyle tips

• Limit caffeine, energy drinks, and alcohol
• Avoid smoking and recreational drugs
• Find healthy ways to cope with stress
• Get regular, moderate exercise (talk to your doctor first)

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, and whole grains. Stay hydrated and avoid very large meals. Gentle exercise like walking, swimming, or yoga is generally fine, but ask your doctor what’s safe for you.

Mental health and emotional wellbeing

Palpitations can cause anxiety, and anxiety can make palpitations worse. It’s a cycle that can be broken with relaxation techniques, counselling, or support from your healthcare team. If you feel overwhelmed, speak to your doctor.

Prevention

You can’t always prevent palpitations, but you can lower your risk by avoiding common triggers, managing stress, and treating underlying health conditions like thyroid problems or anemia.

Screening programmes

If you have a family history of heart rhythm problems, your doctor may suggest regular check-ups or an ECG. There is no routine screening for palpitations in people without symptoms.

Complications

If left untreated

• In rare cases, untreated heart rhythm disorders can lead to stroke or heart failure.
• Frequent palpitations from anxiety can affect quality of life and sleep.

Long-term outlook

For most people, palpitations are harmless and go away on their own or with simple lifestyle changes. Even when linked to a heart condition, treatment is very effective, and most people lead full, active lives. Always seek medical advice for reassurance and proper care.

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