Causes, Symptoms, and When to Seek Help
Heart palpitations can be an unsettling experience. Feeling like your heart is racing, fluttering, or skipping a beat can naturally cause concern, but in many cases, palpitations are harmless. However, they can also be a symptom of an underlying heart condition, which is why it’s important to understand what might be causing them and when to seek medical advice.
As someone who works with patients experiencing heart palpitations, I know how distressing they can be. In this blog, I will look at what palpitations are, their potential causes, and when they might indicate a more serious issue.
What Are Heart Palpitations?
Heart palpitations are the sensation of an irregular or heightened awareness of your heartbeat. This may feel like:
A racing heart (tachycardia)
A fluttering or skipped beat
A pounding sensation in the chest, throat, or neck
They can occur at rest or during activity, and while they’re often brief and harmless, frequent or prolonged episodes should be assessed by a doctor.
Common Causes of Heart Palpitations
Heart palpitations can be triggered by a range of factors, from lifestyle habits to underlying health conditions. The most common causes include:
1. Lifestyle Triggers
In many cases, heart palpitations are caused by everyday factors, such as:
Caffeine and Stimulants – High caffeine intake from coffee, tea, or energy drinks can make the heart beat faster.
Stress and Anxiety – Emotional stress or panic attacks can trigger palpitations.
Exercise – Increased heart rate during physical activity is normal, but in some cases, it may be a sign of an abnormal rhythm.
Smoking and Alcohol – Nicotine and excessive alcohol consumption can disrupt heart rhythm.
Lack of Sleep – Poor sleep patterns can increase the likelihood of palpitations.
In these cases, making simple lifestyle adjustments—such as reducing caffeine intake, managing stress, and improving sleep—can often resolve the issue.
2. Heart-Related Causes
While many heart palpitations are harmless, they can sometimes indicate an underlying heart condition, including:
Arrhythmias
An arrhythmia is an abnormal heart rhythm that can cause the heart to beat too fast, too slow, or irregularly. Common arrhythmias include:
Atrial fibrillation (AF) – A fast, irregular heart rhythm that increases stroke risk.
Supraventricular tachycardia (SVT) – A sudden, rapid heart rate that can cause dizziness or breathlessness.
Bradycardia – A slow heart rate that may lead to fatigue or fainting.
Coronary Artery Disease (CAD)
CAD occurs when the arteries supplying blood to the heart become narrowed or blocked, reducing oxygen flow to the heart muscle.
Palpitations may be accompanied by chest pain or shortness of breath, which can indicate angina or a heart attack.
Heart Valve Disease
If the heart valves do not open or close properly, they can disrupt normal blood flow, leading to palpitations.
Symptoms may include a whooshing sound (heart murmur), dizziness, or breathlessness.
Heart Failure
When the heart isn’t pumping blood efficiently, it can cause fluid build-up, leading to irregular heartbeats and palpitations.
For more information on heart rhythm disorders, visit the British Heart Foundation.
3. Hormonal Changes and Medical Conditions
Hormonal imbalances can affect heart rate and rhythm, particularly in:
Pregnancy – Increased blood volume and hormonal shifts can lead to palpitations.
Menopause – Fluctuating oestrogen levels can cause irregular heartbeats.
Thyroid Disorders – Overactive thyroid (hyperthyroidism) can speed up the heart, while an underactive thyroid (hypothyroidism) may slow it down.
Other medical conditions linked to palpitations include:
Anaemia – Low red blood cell levels can make the heart work harder.
Low Blood Sugar (Hypoglycaemia) – A drop in blood sugar can lead to dizziness and palpitations.
Dehydration – Low fluid levels can cause an imbalance in electrolytes, affecting heart rhythm.
If palpitations are persistent or linked to other symptoms, it’s important to have your heart assessed.
When Should You Be Concerned?
Most heart palpitations are not dangerous, but seek medical attention if you experience:
Palpitations lasting more than a few minutes
Dizziness, fainting, or breathlessness
Chest pain or discomfort
A fast heart rate (over 100 beats per minute at rest)
Palpitations that occur with exercise
These could be signs of a more serious heart condition that requires further investigation. If you experience chest pain, severe breathlessness, or collapse, seek emergency medical help immediately.
How Are Heart Palpitations Diagnosed?
To determine the cause of heart palpitations, your doctor may recommend tests such as:
ECG (Electrocardiogram) – A test that records your heart’s electrical activity.
24-Hour Holter Monitor – A portable ECG worn for 24–48 hours to track irregular rhythms.
Echocardiogram – An ultrasound scan of the heart to assess its structure and function.
Blood Tests – Checks for anaemia, thyroid issues, or electrolyte imbalances.
Exercise Stress Test – Evaluates heart function during physical activity.
If palpitations occur infrequently, your doctor may suggest a longer-term monitor, such as a 7-day event monitor, to capture any abnormal heart rhythms.
Managing and Preventing Heart Palpitations
If heart palpitations are caused by lifestyle factors, making simple changes can reduce their occurrence:
Reduce caffeine, alcohol, and smoking – These are common triggers.
Stay hydrated – Dehydration can lead to electrolyte imbalances.
Manage stress – Breathing exercises, yoga, and mindfulness can help.
Improve sleep habits – Poor sleep can trigger palpitations.
If an underlying heart condition is found, treatment may include:
Medication – Such as beta-blockers or anti-arrhythmic drugs.
Lifestyle modifications – Including heart-healthy diet and exercise.
Medical procedures – In some cases, catheter ablation may be needed for persistent arrhythmias.
For more detailed guidance, visit the NHS palpitations guide.
Conclusion
Heart palpitations are common and, in most cases, harmless. However, frequent or severe palpitations, especially those accompanied by dizziness, chest pain, or shortness of breath, should always be evaluated.
If you are experiencing persistent heart palpitations and need further assessment, contact us here to book an appointment with one of our cardiology specialists. At Heartsure, we provide expert diagnostics and personalised treatment plans to keep your heart health on track.
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