Why do I have palpitations—and when should I see a cardiologist?

Heart palpitations are the sensation of being unusually aware of your heartbeat. You might feel fluttering, pounding, racing, or skipped beats in your chest or throat. While palpitations can be unsettling, they’re often harmless and temporary.

Common everyday causes include stress, anxiety, caffeine, nicotine, dehydration, and lack of sleep. Exercise, fever, and hormonal changes—such as during pregnancy or menopause—can also trigger palpitations. Certain medications, including decongestants and asthma inhalers, may play a role as well. In these cases, palpitations usually settle once the trigger is removed.

However, palpitations can sometimes point to an underlying heart rhythm problem (arrhythmia). Conditions such as atrial fibrillation, supraventricular tachycardia, or premature heartbeats may cause frequent or persistent symptoms. Other medical issues—like anaemia, thyroid disorders, low blood sugar, or electrolyte imbalances—can also affect heart rhythm.

So, when should you seek help from a cardiologist? It’s important to get medical evaluation if palpitations are frequent, worsening, or lasting longer than a few minutes at a time. You should seek prompt medical attention if palpitations are accompanied by chest pain, shortness of breath, dizziness, fainting, or extreme fatigue. These symptoms may indicate a more serious heart condition that needs urgent care.

You should also consider seeing a cardiologist if you have a history of heart disease, high blood pressure, or a family history of sudden cardiac death—even if your palpitations seem mild. A cardiologist can perform tests such as an ECG, heart monitor, blood tests, or an echocardiogram to identify the cause and recommend appropriate treatment.

In many cases, reassurance and simple lifestyle changes are all that’s needed. But listening to your body and knowing when to seek expert help can protect your heart—and your peace of mind.