Almost everyone has felt their heart flutter, race, or skip a beat at some point. These sensations, known as palpitations, can be unsettling, but they are not always a sign of something serious. Understanding what palpitations are, what causes them, and when to seek medical attention can help you feel more in control and less anxious when they occur.
This article will explain palpitations in clear terms, explore when you should be concerned, and help you know what information is helpful to share with your doctor.
What palpitations are
Palpitations are sensations that make you aware of your heartbeat. People often describe them as feeling like:
- Fluttering or rapid beats
- Pounding or thumping in the chest, throat, or neck
- Skipped, extra, or irregular heartbeats
- A feeling that the heart is “flip-flopping” or “racing”
These sensations can last for a few seconds or several minutes. Sometimes, palpitations occur when you are resting or lying down, while at other times they accompany physical activity or emotional stress. In most cases, palpitations are harmless and resolve on their own. However, in some situations, they may point to an underlying medical issue that needs to be addressed.
Common harmless triggers
Most palpitations are not dangerous and are linked to everyday factors. Some of the most common harmless triggers include:
- Stress and anxiety: Emotional stress and anxiety can stimulate your body’s “fight or flight” response, causing your heart to beat faster or more forcefully.
- Caffeine: Drinking coffee, tea, energy drinks, or cola can increase your heart rate, especially if you consume large amounts.
- Alcohol: Some people notice palpitations after drinking alcohol, particularly in excess.
- Nicotine: Smoking or using nicotine-containing products can stimulate the heart.
- Exercise: Physical activity naturally increases your heart rate, which you might notice more during exercise or shortly afterwards.
- Hormonal changes: Women may notice palpitations around their period, during pregnancy, or menopause due to hormonal fluctuations.
- Fever or dehydration: Being unwell with a fever or not drinking enough fluids can also trigger palpitations.
- Certain medications: Some medicines, such as decongestants, asthma inhalers, or thyroid medications, may cause your heart to beat faster.
In these situations, palpitations are usually short-lived and resolve once the trigger is removed or passes. If you notice a pattern—such as palpitations after your morning coffee or during stressful meetings—this can help you identify and manage the cause.
When palpitations can be dangerous
While most palpitations are harmless, some can be a sign of a more serious underlying heart or medical condition. It is important to pay attention to the context, frequency, and any associated symptoms. You should seek medical attention if:
- Your palpitations are accompanied by chest pain, pressure, or discomfort
- You feel lightheaded, dizzy, or faint
- You experience shortness of breath or difficulty breathing
- Your heart is racing for a long period (more than a few minutes) without a clear reason
- You have a known history of heart disease or risk factors (such as high blood pressure, diabetes, or a family history of heart problems)
- You notice a very irregular or rapid heartbeat at rest
In rare cases, palpitations can be due to abnormal heart rhythms (arrhythmias), heart valve problems, thyroid disorders, or other medical conditions. If you are ever in doubt, it is safer to consult a healthcare professional, especially if you develop new symptoms or your palpitations change in character or frequency.
Call emergency services immediately if you have palpitations with severe chest pain, fainting, or difficulty breathing.
What to track before seeing a doctor
If you decide to see a doctor about palpitations, bringing detailed information can help with diagnosis and management. Consider tracking the following:
- When they occur: Note the time of day, your activity, or any emotional triggers.
- How long they last: Record the duration—from a few seconds to several minutes or longer.
- What they feel like: Try to describe the sensation—racing, skipping, pounding, irregular, etc.
- Associated symptoms: Write down if you experience chest pain, shortness of breath, dizziness, sweating, or fainting.
- Possible triggers: Observe if palpitations follow caffeine, alcohol, medications, or stress.
- Medical history: Inform your doctor about any heart conditions, thyroid issues, or other chronic illnesses you have.
- Family history: Mention if close relatives have had heart disease, abnormal heart rhythms, or sudden cardiac events.
Keeping a diary or log of your symptoms can make it easier to spot patterns and provide your doctor with valuable information. In some cases, your doctor may ask you to capture your pulse rate or even use a smartphone or wearable device to record an episode, if possible.
Typical tests and next steps
If your doctor thinks further evaluation is needed, they may recommend a range of tests to understand what is causing your palpitations. Common investigations include:
- Physical examination: Your doctor will listen to your heart, check your pulse, and look for any signs of underlying illness.
- Electrocardiogram (ECG): This simple, painless test records your heart’s electrical activity and can detect many types of abnormal heart rhythms.
- Holter monitor or event recorder: If palpitations are infrequent, you may be asked to wear a portable ECG device for 24 hours or longer to capture episodes as they occur.
- Blood tests: These can identify problems such as thyroid disease, electrolyte imbalances, or anaemia that may affect your heart.
- Echocardiogram: An ultrasound scan of the heart may be done to check for structural problems or valve issues.
- Exercise stress test: Sometimes, your doctor will see how your heart responds to physical activity.
After these investigations, your doctor will discuss the results with you and explain whether any treatment or further follow-up is necessary. In many cases, reassurance and avoiding known triggers are all that is needed. If a specific heart rhythm problem or other condition is found, your doctor will guide you on the best next steps, which may include medication, lifestyle changes, or referral to a heart specialist.
If you are interested in learning about related heart health issues, you may find it helpful to read about the subtle warning signs of high blood pressure in this detailed overview of symptoms people often miss.
Remember, palpitations are very common and usually not a reason to panic. By understanding your symptoms and knowing when to seek help, you can manage palpitations with greater confidence. If you are ever concerned, it is always best to consult a healthcare professional for advice tailored to your individual situation.
