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Palpitations
Palpitations are one of the most common symptoms people experience when something feels “not quite right” with their heart. They describe the unusual awareness of your heartbeat—whether it feels fast, forceful, irregular, fluttery, or as though beats are being missed or added. While palpitations are often harmless, they can sometimes signal an underlying heart rhythm or medical condition that deserves prompt assessment.
What Do Palpitations Feel Like?
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People describe palpitations in different ways. You might notice:
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A racing or pounding heartbeat
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Irregular or “jumping” beats
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Flutters or vibrations in the chest
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Pauses followed by a heavy thump
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Runs of fast heartbeats
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A general sense that your heart rhythm feels unusual
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Palpitations can affect anyone—men, women, children, and teenagers—and may occur at rest, during exercise, or even during sleep.
Are Palpitations Serious?
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In many cases, palpitations are triggered by temporary, non-serious factors such as caffeine, stress, dehydration, or lack of sleep. However, because palpitations can also be the first sign of an underlying heart rhythm problem, such as atrial fibrillation, SVT, or ventricular ectopics, it is important to be assessed by a cardiovascular specialist if:
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Your palpitations are persistent or worsening
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They occur with dizziness, breathlessness, chest discomfort, or fainting
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You have a known heart condition or family history of heart rhythm disorders
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You are unsure what is causing them
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Prompt evaluation helps distinguish benign palpitations from those needing treatment.
Common Causes of Palpitations
Palpitations have a wide range of triggers—from lifestyle factors to medical conditions. These may include:
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Lifestyle and physiological causes
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Stress or anxiety
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Poor sleep
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Excess caffeine or energy drinks
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Alcohol
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Smoking
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Recreational drugs
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Dehydration
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Hormonal changes (menopause, pregnancy, thyroid conditions)
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Cardiac causes
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Supraventricular tachycardia (SVT)
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Atrial fibrillation or atrial flutter
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Ventricular ectopic beats (PVCs)
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Structural heart disease
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Cardiomyopathy
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Heart valve problems
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Previous heart attack or coronary artery disease
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Other medical causes
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Anaemia
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Diabetes
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Fever or infection
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Thyroid overactivity
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Electrolyte disturbances
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Side effects of medications (e.g. some asthma inhalers, antidepressants)
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Because the range of causes is so broad, an expert assessment is key.
Do You Need Tests?
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During your consultation, I will take a detailed history of:
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When your palpitations occur
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How long they last
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Whether you experience associated symptoms
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Any lifestyle factors or medical conditions that might be relevant
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A physical examination, heart rate assessment, and blood pressure measurement are usually the first steps. Simple lifestyle changes—such as reducing caffeine, improving sleep, and managing stress—can help identify triggers and reduce episodes.
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If palpitations occur frequently, or if there are concerns about an irregular rhythm, further tests may be recommended.
Investigations for Palpitations
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Depending on your symptoms, you may benefit from one or more of the following:
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Electrocardiogram (ECG) – a quick test that records your heart’s electrical activity
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Ambulatory ECG monitoring (24–48 hour Holter or longer event monitoring) – to capture palpitations that come and go
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Echocardiogram – an ultrasound scan to assess heart valves, chambers, and function
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Blood tests – including thyroid function, electrolytes, and markers of anaemia
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Exercise testing – to assess the rhythm during exertion
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These investigations help pinpoint the cause of your palpitations and guide the right treatment plan.
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Do palpitations always appear on an ECG?
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Not always. If palpitations are infrequent, a standard ECG may appear normal. That’s why longer-term monitoring is often more effective for detecting intermittent rhythm problems.
Your Personalised Treatment Plan
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If the cause is benign, simple reassurance and lifestyle adjustments may be all that’s required. When needed, treatment may include:
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Medication to slow or regulate the heartbeat
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Management of underlying conditions such as anaemia, thyroid disorders, or anxiety
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Catheter ablation for certain rhythm disorders (e.g. SVT, atrial fibrillation, troublesome ectopics)
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Further rhythm monitoring if symptoms evolve
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My aim is to provide clarity, reassurance, and a tailored plan that supports your long-term heart health.
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