Palpitations

A palpitation is when you suddenly become aware of your heartbeat. This can feel alarming but is usually nothing to worry about. Normally, palpitations come and go quickly without any treatment.

See your doctor if you have palpitations accompanied by other symptoms such as dizziness, shortness of breath and a feeling of anxiety, or if you are concerned.   

If you get palpitations that are severe or last for more than a few minutes call 111 and ask for an ambulance.

What are palpitations?

Your heart usually beats about 60 to 100 times per minute, it’s regular and you don’t normally feel it. A heart palpitation is when you are aware of your heart beating. It may feel like your heart has added or missed a beat. It may feel fast or slow. Some people say it feels like their heart is racing, fluttering or pounding.

What causes palpitations?

Lifestyle factors

Palpitations are often brought on by lifestyle factors such as:

  • Nicotine – found in cigarettes
  • Caffeine – found in coffee, tea, energy drinks, soft drinks
  • Alcohol
  • Recreational drugs
  • Stress
  • Strenuous physical activity or exercise

If you think lifestyle factors are causing your palpitations, take action to reduce their effect on you. This may involve stopping smoking, drinking less caffeine and alcohol, avoiding recreational drugs, using relaxation techniques to reduce your stress levels or choosing a less intense form of exercise.

Periods/ pregnancy/ menopause

Women may experience palpitations due to hormonal fluctuations and other changes caused by periods (especially heavy bleeding), pregnancy or menopause. These normally go away without causing any ongoing problems. 

Panic attacks

Palpitations accompanied by the sensation of fear, anxiety and panic may due to panic attacks. These can be very unsettling but normally does not cause any serious problems. Read more about panic attacks.

Health conditions

Palpitations can be also caused by health conditions such as: 

Medications

Some medications – such as asthma or COPD puffers or inhalers, can also cause palpitations. Talk to your doctor if you think medications are causing your palpitations. Do not stop taking any prescribed medication until after you have sought advice.

What should I do if I have palpitations?

Most of the time palpitations are harmless and will go away on their own. Sometimes they can be a sign of something more serious. Call an ambulance if you:

  • have palpitations that do not go away within a few minutes
  • have any chest pain with palpitations
  • become breathlessness and find it difficult to breathe with palpitations
  • pass out (faint) or feel as if you are going to pass out
  • have had heart problems in the past and have palpitations.

If the palpitations stop on their own and don't make you feel unwell you should make an appointment to see your doctor. Keep a diary of when they happen and how long they last. This information will help your doctor understand what is causing your palpitations.

Seeing your doctor about palpitations

If you are worried, especially if your palpitations are irregular or make you feel unwell, see your doctor. They will ask you questions about your symptoms and medical history. They may ask you to have some tests, such as a blood test. This can see if you have an underlying health condition that might cause the palpitations.

To find out what type of palpitation you are having, you might be asked to have a test called an electrocardiogram (ECG). This will record what is happening to your heart rate and rhythm at that moment in time. If your palpitations come and go, the ECG may not show them. 

What types of palpitations are there?

There are different types of palpitations, the most common are listed in the table below. 

Type

Description

Ectopic beats – extra beats

You might feel extra heartbeats. These are called ectopic beats. This can feel like your heart has skipped a beat and feel irregular. Sometimes it feels like a stronger beat than usual. Ectopic beats can be felt when you are resting, but you may not feel them when you are active.

Sinus tachycardia – fast but regular

You may feel that your heartbeat is faster than usual but it is still regular. There are many causes and can be normal when you exercise. Usually, this is harmless and settles by itself.

Atrial fibrillation – very fast and irregular

Atrial fibrillation (AF) is when your heartbeat is very fast and irregular. It can make you feel short of breath, dizzy and tired. It is more common if you are older, if you already have heart problems or you have high blood pressure. Untreated, AF can cause stroke. See your GP or healthcare provider who will talk to you about treatment options. Read more about atrial fibrillation

Supraventricular tachycardia (SVT) – very, very fast and regular

An SVT is very, very fast and regular heart rate. You may feel your heart racing but it then slows down by itself. Young people can get SVT. You often don’t need treatment as it’s usually harmless. If it keeps happening you may need to see your GP.

What treatment is available?

Depending on the type of palpitations and your symptoms, you may not need any treatment. The palpitations may go away by themselves. 

You may notice some things that cause your palpitations from the list of causes above. If possible, they should be avoided. For example, if you notice palpitations after having caffeine, you may need to stop or reduce how much caffeine you have. If you feel stressed or anxious, try to identify what is causing this and find ways to relax.

If your palpitations are caused by atrial fibrillation, you may be prescribed medication to help prevent blood clots and restore your heart's normal rhythm and speed. Read more about treatment for atrial fibrillation. 

Learn more & references

Palpitations Patient UK
Heart arrhythmias and palpitations Better Health Channel (Australia)
Heart Palpitations and Ectopic Beats NHS Choices (UK)