What are palpitations?
Palpitations are the sensation of being unusually aware of your heartbeat. They may feel like fluttering, pounding, racing, or skipping beats in the chest. While palpitations are often harmless, they can sometimes signal an underlying heart condition. Understanding what causes them, when to seek medical advice, and the gold-standard treatments available is important for protecting long-term heart health.
What do palpitations feel like?
Patients describe palpitations in different ways. Common sensations include:
- A rapid or racing heartbeat
- Skipped or extra beats
- A fluttering or thumping feeling in the chest
- Heartbeats that are stronger than usual
They may last for only a few seconds or continue for minutes at a time. Palpitations can occur at rest, during exercise, or even while lying down.
What causes palpitations?
Palpitations can be triggered by many factors, including:
- Stress, anxiety or panic attacks
- Excess caffeine, alcohol or nicotine
- Lack of sleep
- Certain medications
- Hormonal changes, such as during pregnancy or menopause
In other cases, palpitations are linked to heart conditions, including arrhythmias (abnormal heart rhythms), problems with the heart valves, or structural heart disease. Identifying the cause is key to determining whether treatment is needed.
Are palpitations always dangerous?
Most palpitations are benign and not linked to serious heart problems. However, they should be investigated if they occur frequently, are prolonged, or are accompanied by other symptoms such as chest pain, dizziness, shortness of breath or fainting. These signs may indicate an underlying heart condition that requires specialist care.
How are palpitations diagnosed?
Doctors use a combination of medical history, physical examination and heart tests to find the cause. Investigations may include:
- Electrocardiogram (ECG) to record the heart’s rhythm
- Echocardiogram to assess heart structure and function
- Holter monitoring (24 to 48-hour ECG recording) to detect intermittent arrhythmias
- Blood tests to check for thyroid or electrolyte problems
This approach helps distinguish between harmless palpitations and those requiring treatment.
What is the gold-standard treatment?
The best treatment depends on the underlying cause. Options include:
- Lifestyle changes: Reducing caffeine and alcohol, improving sleep, and managing stress can often reduce palpitations.
- Medication: Beta-blockers or anti-arrhythmic drugs may be prescribed for certain rhythm disorders.
- Catheter ablation: A minimally invasive procedure to treat abnormal electrical pathways in the heart, often considered the gold-standard for specific arrhythmias such as atrial fibrillation or supraventricular tachycardia.
- Device therapy: Pacemakers or implantable cardioverter-defibrillators (ICDs) may be recommended for patients with serious rhythm problems.
When should I see a doctor about palpitations?
If palpitations are frequent, troubling, or associated with other symptoms, it is important to seek medical advice. Even when they turn out to be harmless, a heart check-up provides peace of mind. With accurate diagnosis and access to modern gold-standard treatments, patients can manage palpitations effectively and protect their long-term heart health.