Palpitations A&E leaflet

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What are heart palpitations?

Heart palpitations are when you suddenly become more aware of your heartbeat. Palpitations can feel worrying, but in most cases they are harmless and do not need treatment. 

You may feel: 

• Pounding 
• Fluttering 
• Racing or skipping beats 

These feelings can last seconds or minutes. You might notice them more at night, when resting or when you are anxious or alone. 

You may also feel your heartbeat in your throat or neck. 

Sometimes, you may feel an extra or missed beat. These are called ectopic beats and are usually nothing to worry about. 

What tests might I have?

During your visit, we may have done: 

• A heart trace (ECG) 
• Blood pressure, heart rate, and temperature checks 
• Blood tests or a chest X-ray 

If you keep having palpitations, speak to your GP. They may arrange: 

• A 24-hour ECG monitor 
• Other outpatient tests 

What can cause palpitations?

Palpitations can happen for many reasons. Common causes include: 

Lifestyle triggers 

• Too much caffeine (like coffee, energy drinks) 
• Alcohol 
• Smoking 
• Recreational drugs 
• Lack of sleep 
• Rich or spicy food 
• Strenuous exercise 

These triggers usually cause short-lived palpitations. Avoiding them can help prevent future episodes. 

Emotional and psychological factors

• Stress 
• Anxiety 
• Panic attacks 
• Excitement 

Breathing exercises and relaxation techniques can help. 

Hormone changes

• Periods 
• Pregnancy 
• Menopause 

These palpitations are usually temporary. 

Heart rhythm problems (arrhythmias)

Specific heart rhythms such as the following may cause palpitations: 

• Atrial fibrillation 
• Atrial flutter 
• Supraventricular tachycardia (SVT) 
• Ventricular tachycardia 

Heart conditions

• Valve problems 
• Enlarged heart 
• Weakened heart pump (heart failure)  

Other health conditions

• Thyroid problems 
• Anaemia 
• Low blood sugar 
• Fever 
• Dehydration 
• Low blood pressure (especially when standing) 

When should I see my GP?

You do not usually need to see your GP if the palpitations pass quickly and occur only occasionally. They are unlikely to be caused by a serious problem and probably won’t need treatment. 

You should see your GP if: 

• Palpitations last a long time 
• They are getting worse 
• You have a history of heart problems 
• You are worried about them 

Your GP may arrange tests or refer you to a heart specialist. 

When to seek emergency help

These could be signs of a serious or life-threatening heart problem. Don’t wait, get checked as soon as possible. 

Further support