Unravelling Heart Palpitations: When to Pay Attention
By Dr Nabila Laskar — published June 2026.
Ever felt your heart skip a beat, flutter, or race unexpectedly? These sensations, known as heart palpitations, can be unsettling. Dr Nabila Laskar explains what causes them and when they might signal a more serious issue.
What Exactly Are Heart Palpitations?
Many of us have experienced that peculiar sensation of our heart beating differently to its usual rhythm. Perhaps it felt like a brief flutter in your chest, a pounding sensation after a sudden scare, or even your heart skipping a beat. These are all common descriptions of heart palpitations.
Essentially, heart palpitations are a heightened awareness of your own heartbeat. Your heart is always working, of course, but most of the time we don't feel it. When you do, it can manifest in various ways – from a subtle throb to a more dramatic, rapid pounding.
It's important to remember that in many cases, palpitations are harmless and are simply your body reacting to everyday triggers. However, they can sometimes be a sign of an underlying medical condition, so understanding when to seek medical advice is key.
Key facts:
- • Heart palpitations are a subjective awareness of your own heartbeat.
- • They can feel like fluttering, pounding, racing, or skipped beats.
- • Often benign, but can sometimes indicate an underlying health issue.
- • Identifying personal triggers can help manage them.
Common Triggers for Palpitations
Our hearts are highly responsive organs, and many non-cardiac factors can influence their rhythm and the way we perceive them. Understanding these common triggers can often alleviate anxiety about palpitations.
Lifestyle & Emotional Factors
- • Stress and Anxiety: When you're stressed, your body releases adrenaline, a 'fight or flight' hormone that speeds up your heart rate.
- • Caffeine Intake: Found in coffee, tea, and energy drinks, caffeine is a stimulant that can make your heart beat faster or irregularly.
- • Nicotine: Present in tobacco products, nicotine also acts as a stimulant on the heart.
- • Alcohol: Excessive alcohol consumption can affect the heart's electrical system, leading to palpitations, sometimes known as 'holiday heart syndrome'.
- • Lack of Sleep: Sleep deprivation can disrupt your body's natural rhythms and hormone balance, potentially triggering palpitations.
- • Strenuous Exercise: While healthy, intense exercise can temporarily increase heart rate, which you might feel more acutely.
Physical & Medical Factors
- • Dehydration: Not drinking enough fluids can affect electrolyte balance, impacting heart function.
- • Hormonal Changes: Fluctuations during menstruation, pregnancy, or menopause can often lead to palpitations.
- • Fever: Your heart works harder to pump blood when you have a fever.
- • Certain Medications: Some cold remedies (decongestants), asthma inhalers, and even thyroid medications can cause palpitations as a side effect.
- • Low Blood Sugar: Hypoglycaemia can trigger an adrenaline release, leading to a fast heartbeat.
- • Anaemia: A low red blood cell count means your heart has to pump harder to get oxygen around your body.
When Palpitations Might Signal a Heart Condition
While often benign, palpitations can sometimes be a symptom of an underlying cardiac issue. It's crucial to understand the red flags that warrant a visit to your GP or cardiologist.
Conditions that can cause palpitations include:
- Arrhythmias: These are irregular heart rhythms, where the heart beats too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Examples include atrial fibrillation or supraventricular tachycardia.
- Heart Valve Problems: Issues with the heart's valves, such as mitral valve prolapse, can sometimes cause palpitations.
- Heart Muscle Disease (Cardiomyopathy): Conditions that affect the heart muscle can impact its ability to pump blood effectively and alter its rhythm.
- Coronary Artery Disease: Blockages in the heart's arteries can sometimes manifest with palpitations, though chest pain is a more common symptom.
- Overactive Thyroid (Hyperthyroidism): An excess of thyroid hormones can cause your heart to beat too quickly.
What to Do When You Experience Palpitations
If you're experiencing palpitations, observing and documenting them can be very helpful for your doctor.
1. Stay Calm and Note Your Symptoms
Try to relax. Panic can worsen palpitations. Take deep breaths. Note down how often they occur, how long they last, and what they feel like (e.g., fluttering, pounding, skipped beats).
2. Identify Potential Triggers
Think about what you were doing or consuming just before the palpitations started. Had you just had a strong coffee? Were you feeling particularly stressed? This information is invaluable.
3. Consult Your GP
Schedule an appointment with your GP. They will ask detailed questions about your symptoms, medical history, and lifestyle. They might perform an initial examination, which may include listening to your heart and taking your pulse and blood pressure.
4. Potential Further Investigations
Depending on your symptoms and the GP's findings, further tests might be recommended. These could include an Electrocardiogram (ECG) to record your heart's electrical activity, a Holter monitor (a portable ECG worn for 24-48 hours) to capture intermittent palpitations, or blood tests to check for anaemia or thyroid issues. In some cases, an echocardiogram (ultrasound of the heart) may be considered.
Managing Palpitations and Lifestyle Adjustments
For many, managing palpitations involves lifestyle changes to minimise triggers.
Can reducing stress really help?
Absolutely. Stress and anxiety are major triggers. Techniques like mindfulness, meditation, yoga, or even just regular gentle exercise can make a significant difference in reducing the frequency and intensity of palpitations.
What about diet?
Reducing caffeine, alcohol, and nicotine intake is often recommended. Eating regular, balanced meals helps maintain stable blood sugar levels, and staying well-hydrated is crucial for overall heart health.
Should I still exercise?
Unless advised otherwise by your doctor, continuing regular, moderate exercise is highly beneficial for heart health. If strenuous activity triggers your palpitations, discuss this with your doctor to find a suitable exercise routine.
When to Seek Urgent Medical Attention
Don't Ignore These Warning Signs
While many palpitations are harmless, certain accompanying symptoms suggest a more serious underlying issue and warrant immediate medical attention. If you experience palpitations along with any of the following, please seek urgent help:
- • Dizziness or lightheadedness, especially if it leads to fainting or nearly fainting.
- • Chest pain or discomfort, particularly if it feels like pressure, squeezing, or fullness.
- • Shortness of breath, especially if it's new or worsening.
- • Severe weakness or fatigue.
- • If you have a known heart condition and your palpitations suddenly change in nature or frequency.
Understanding your body and its signals is paramount. While palpitations can be alarming, most are not a cause for serious concern. However, by being aware of when to seek professional advice, you can ensure that any potential underlying conditions are identified and managed effectively, keeping your heart healthy and strong.