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Palpitations

A palpitation is a perceived irregular heartbeat, which is either rapid or abnormal in some way. They are usually intermittent and can occur without being an indication of another condition. 

  • Often caused by cardiac arrhythmias
  • Can help to avoid possible stimulants
  • Second most common cardiology complaint

Our online video consultation service is available should you wish to speak to a doctor about palpitations, from 9.30am to 4.30pm, five days a week. Our clinicians will be able to advise you on whether your palpitations need further examination and how to avoid triggering them.

  • UK prescribers
  • 24 hour delivery
  • Secured payment
Possible causes

You should go to hospital immediately if you experience palpitations and any of the following: breathlessness; pain in the chest; dizziness; feeling faint; any signs of an infection, such as a fever.

It’s likely that you will be referred to a cardiology department if you have a family history of fatal heart problems.

The causes of heart palpitations can be broadly separated into two categories: cardiac disorders and non-cardiac disorders.

Non-cardiac disorders

There are common lifestyle factors and triggers that may lead to heart palpitations. In anxiety and panic disorders, palpitations are often a symptom of a panic attack. Other conditions that can cause palpitations include anaemia and hyperthyroidism. 

Lifestyle factors that may lead to palpitations include alcohol use (particularly binge-drinking), caffeine consumption and drug use.

Cardiac disorders

Cardiac disorders can be caused by different types of tachycardia. A tachycardia is a type of arrhythmia (irregular heartbeat) in which the heart beats faster than it should at rest. The heart rate is managed by electrical signals and a tachycardia results from an abnormally high production of these signals, which quickens the heart rate.

Tachycardias can be supraventricular (SVT), which means the irregular signals are present in the upper part of the heart, or ventricular (VT), when they occur in the ventricles (two compartments in the lower part of the heart). 

Types of tachycardia that can cause palpitations include:

  • Atrial fibrillation (a type of SVT caused by irregular signals in the atria, the upper part of the heart)
  • Atrial flutter (a very fast heart beat at a regular rate, again caused by irregular signals in the atria)
  • Ventricular fibrillation (a type of VT caused by erratic signals in the ventricles)

There are also many other types of heart problems that can cause heart palpitations, including heart failure, cardiomyopathy (the thickening of the heart muscle), and congenital heart disease.

High blood pressure can increase the likelihood of palpitations in some cases.

Diagnosing the cause of palpitations

In order to diagnose the cause of heart palpitations, a doctor will look to establish what your  medical history is, before conducting an examination and tests.

A doctor will ascertain if you understand what palpitations are, and describe them in more detail (such as how long they last and how frequently they occur). They will also ask you if your heart rate is regular or irregular, and to try to mimic the rhythm of the beat. 

They may enquire as to whether any other symptoms have accompanied your palpitations, such as a tightness in the chest. Possible lifestyle causes may also be explored, such as recent caffeine or alcohol consumption, or whether any recreational drugs have been taken.

The next stage in the diagnosis will involve an examination. If the palpitations are currently taking place, a doctor can simply check your pulse. This can reveal how strong the heartbeat is, whether it is regular or irregular, and how fast it is. Each of these components may factor into a diagnosis. For example, a chaotic irregular beat would suggest an atrial flutter.

It’s likely that your doctor will want to investigate the cause of your palpitations further, and there are a number of tests that can be taken. A 12-lead ECG is the most common test for palpitations. It uses sensors that can be attached to the skin to record electrical signals that are produced by the heart.

Blood tests, an echocardiogram (which shows the structure of the heart and is used if cardiomyopathy is suspected), and exercise tests (using a treadmill which is connected to an ECG) can also be helpful in diagnosing the cause.

Page last reviewed:  11/06/2020
Types of Treatment

How are palpitations treated?

Typically, palpitations are nothing to worry about. However, they can be an indication of a serious condition, and treatment can sometimes involve a referral to a specialist and urgent hospital admission.

You should go to hospital immediately if you experience palpitations and any of the following symptoms: breathlessness; chest pain; dizziness; feeling faint; any indications of an infection, for example, a fever.

If you have a family history of fatal heart problems, you will typically be referred to a cardiology department. 

If there is no obvious cause that requires treatment in primary care, there are a number of suggestions that a doctor may make to help with palpitations. If the problem is psychological, it can help to try and ease feelings of anxiety and stress. This can be done through relaxation exercises, and cognitive behavioural therapy (CBT) may help to change thought patterns and behaviour. It can also be beneficial to avoid alcohol, caffeine, nicotine and recreational drugs.

Palpitations can be a frightening experience for some people, although in most cases they resolve by themselves. If you are worried about heart palpitations, you can contact one of our GMC-registered doctors via our online video consultation service. You can arrange to speak to one of our clinicians between 9.30am and 4.30pm, five days a week. 

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have palpitations for?

It’s common to have heart palpitations for a few seconds or minutes without any particular underlying cause.

However, it may be an indication of something serious if they are particularly forceful and do not resolve themselves for an extended period.

Are palpitations serious?

Palpitations are not usually an indication of a serious condition, as they are often caused by triggers related to lifestyle such as excessive drinking or caffeine intake.

However, if palpitations persist or you have a history of heart problems in the family, you should contact your GP.

Palpitations accompanied by breathing problems, chest pain, feeling dizzy or faint, or fever should be treated as a medical emergency, and require hospital admission.

Can I get treatment for palpitations?

In most cases you will not need treatment for heart palpitations. Avoiding certain triggers such as excess alcohol consumption and drinking too much caffeine may help.

There are no particular medications that can be prescribed for heart palpitations, but there are for potential causes of palpitations, such as high blood pressure, for which various treatments, such as lisinopril, are available.

Sometimes cardiac disorders, such as supraventricular tachycardia, will need to be treated in hospital - particularly if symptoms persist for long periods. Adenosine or verapamil are examples of drugs used to help bring an irregular heartbeat under control.

How can I prevent palpitations?

It is not always possible to prevent palpitations, as they cannot be predicted. However, if palpitations are induced by stress or anxiety, it can help to try to manage these feelings.

Avoiding stimulants and other possible triggers is encouraged, as well as staying hydrated.

Can I speak to a doctor online about palpitations?

If you are worried about heart palpitations, you can use our online video consultation service to speak to one of our GMC-registered clinicians between 9.30am and 4.30pm, Monday to Friday. They can offer advice about managing palpitations and whether your symptoms require further investigation. Our clinicians can also issue prescriptions and referrals to specialists where appropriate. 

Page last reviewed:  11/06/2020

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