Heart Palpitations
Heart palpitations — the awareness of your own heartbeat, whether it feels fast, irregular, pounding, or fluttering — are very common and usually harmless. However, some palpitations are caused by underlying heart conditions that require assessment. A proper evaluation provides reassurance or identifies the cause and appropriate treatment.
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On this page
This page provides general health information only. If palpitations are accompanied by chest pain, fainting, or severe breathlessness, call 112 immediately.
What causes palpitations?
Palpitations have a wide range of causes — most are benign, but some require investigation:
Common non-cardiac causes
- Caffeine, alcohol, nicotine, and recreational drugs
- Anxiety, stress, and panic attacks
- Dehydration and electrolyte imbalances
- Thyroid disorders — both overactive and underactive thyroid can cause palpitations
- Anaemia and low blood sugar
- Certain medications including decongestants, asthma inhalers, and stimulants
- Hormonal changes — pregnancy, menopause, and menstrual cycle
Cardiac causes
- Ectopic beats (extra heartbeats) — very common, usually harmless
- Atrial fibrillation — an irregular heart rhythm requiring assessment and treatment
- Supraventricular tachycardia (SVT) — episodes of rapid heart rate
- Other arrhythmias — less common but requiring cardiac investigation
How palpitations feel
- A fluttering or flapping sensation in the chest
- A pounding or racing heartbeat
- A feeling that the heart has "skipped a beat" or given an extra thump
- An irregular or uneven heartbeat
- Awareness of the heartbeat in the throat or neck
When palpitations are urgent
Call 112 immediately if palpitations are accompanied by chest pain or tightness, severe breathlessness, fainting or near-fainting, or if they occur in someone with known heart disease. These may indicate a serious cardiac arrhythmia requiring emergency treatment.
When to see a doctor
See a doctor if palpitations are new, frequent, prolonged, or associated with dizziness, breathlessness, or reduced exercise tolerance. An ECG is often the first investigation and can be arranged quickly through our doctors.
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Treatment options
- Lifestyle modifications — reducing caffeine, alcohol, and stress where these are contributing factors
- Treating underlying causes — thyroid disease, anaemia, anxiety, or electrolyte imbalance
- Beta-blockers — for symptomatic ectopic beats or mild arrhythmias
- Antiarrhythmic medication — for atrial fibrillation and SVT
- Cardioversion or ablation — for persistent atrial fibrillation or recurrent SVT
- Anticoagulation — for atrial fibrillation to reduce stroke risk
How eMedClinic can help
Our cardiologists provide online assessments for palpitations, arrange ECGs and blood tests, review results, and advise on treatment. We can also review medications and lifestyle factors that may be contributing, and provide urgent referrals where a cardiac arrhythmia requires specialist assessment.
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