London Heart


What are palpitations?

Palpitations are a symptom, rather than a single condition in themselves. Palpitations basically means an awareness of your heart beating, or the sensation that your heart is pounding or beating harder or faster than usual. It might also feel like your heart is skipping beats or adding in extra beats, and beating with an irregular rhythm.

Palpitations are very common and can affect men and women of all ages, including children and teenagers. Most of the time, they are harmless and not a sign of anything seriously wrong with your heart. However, they can also be a symptom of a range of conditions that may need to be investigated and treated, so it is always best to get things checked.

Are you experiencing palpitations? Leading London cardiologist Dr Syed Ahsan treats patients with a wide range of heart-related symptoms and conditions: Get in touch via our online booking form to book a consultation or give us a call on 0203 303 0325.

Are palpitations serious?

This depends on the underlying cause. Palpitations are very common and there are lots of causes – ranging from harmless, short-term reactions (such as drinking too much coffee, or experiencing a sudden stress or shock), to serious medical conditions (such as atrial fibrillation). In the vast majority of cases, palpitations are not serious, but it’s important to investigate and rule out any potential underlying causes, and there may still be steps you can take to help manage palpitations even if they aren’t linked to a more serious condition.
Our blog – ‘Help, my heart beat doesn’t feel right!’ – explains more.

What are the causes of palpitations?

Most of the time, there is no particular cause. However, things like stress, anxiety and sleep deprivation can all lead to episodes of palpitations, along with stimulants such as caffeine or energy drinks. Drugs such as amphetamines, cocaine or cannabis, plus alcohol can also cause palpitations. Certain medications, such as certain asthma treatments and antidepressants, can also cause palpitations as a side-effect.

There’s also a wide range of underlying health conditions that may cause palpitations. This includes conditions directly related to the heart, as well as a number of other conditions originating elsewhere in the body.

Hormonal imbalances, such as those that can occur with certain thyroid disorders, pregnancy or the menopause, can all be associated with palpitations, along with diabetes and anaemia, for example.

In terms of the heart itself, structural heart disease, or arrhythmia (abnormal heart rhythm/heart rhythm disorder) are among the known causes of palpitations. If this is the case, most commonly ventricular ectopics – extra beats originating from the bottom of the heart – are the cause. These may feel as though you heart is skipping a beat or stopping, but most of the time this is completely harmless. Other conditions include supraventricular tachycardia (SVT), which leads to a fast racing heart rhythm which may be associated with dizziness or shortness of breath, and atrial fibrillation, characterised by a chaotic irregular heart rhythm.

Should I have tests for palpitations?

The first step is usually discussing your symptoms with your doctor, as well as your general health history and any lifestyle factors that might be relevant, plus simple tests like listening to your pulse and heart rate, and taking your blood pressure. Palpitations don’t always require further medical investigations and often, some simple lifestyle changes can help identify triggers and manage the episodes.

For many people, palpitations are linked with stress and anxiety so it can be very beneficial to address these things, and take any necessary steps to manage these. This might include discussing your workload with your boss if that is a problem, following a healthy, balanced diet and getting regular exercise and plenty of sleep, or seeking psychological treatments such as counselling or CBT.

If palpitations are associated with an irregular heart rate, or they’re ongoing and also making you feel unwell, fatigued or breathless or you’re experiencing chest pain, for example – or if there are other heart health risk factors, such as being an older age or having a family history of conditions like atrial fibrillation, stroke or heart disease – then a number of further tests can help determine any underlying causes that may need to be monitored or treated. Our information video on when to seek medical help for palpitations explains more.

What investigations may I need, and do palpitations always show up on an ECG?

Palpitations don’t always show up on an electrocardiogram (ECG), but you may still be sent for one as these can be useful in detecting other possible abnormalities with the heart and heart rhythm. You may also be sent for an ultrasound scan of the heart (echocardiogram) and fitted with an ambulatory ECG monitor, which will monitor your heart beat over a longer period of time. The results of these investigations will determine the next steps and treatment if required. Our information video on tests for palpitations explains more.