Palpitations are a symptom and are an awareness or feeling of your heart beating. You may be aware of your heart beating fast, skipping a beat or beating irregularly.
There are many different causes of palpitations. Most of the time palpitations are benign although sometimes palpitations can be due to an abnormal heart rhythm.
Most of the time there is no particular cause. However stress, anxiety and sleep deprivation can lead to episodes. Other causes include certain stimulants such as caffeine or energy drinks. Drugs such as amphetamines, cocaine or cannabis can also cause symptoms. Alcohol is another common cause.
Certain medications such as drugs used for asthma or antidepressants can also cause palpitations as a side effect. Hormonal imbalance such as that seen with certain thyroid disorders, pregnancy or the menopause may all lead to symptoms Other underlying medical problems such as structural heart disease, anaemia or diabetes may also cause palpitations.
An abnormal heart rhythm may be the cause in some cases. There are different types of heart rhythm disorder that may cause these symptoms. Most commonly ventricular ectopics, which are extra beats originating from the bottom of your heart, are the cause. These may make you feel as if you heart is skipping a beat or stopping and are completely benign most of the time. Other conditions include supraventricular tachycardia (SVT) which leads to a fast racing heart rhythm which may be associated with dizziness or shortness of breath. Atrial fibrillation is a chaotic irregular heart rhythm that can lead to a feeling of an irregular heart beat.
There are also other heart rhythm disorders that may cause symptoms.
Often simply making lifestyle changes and eliminating the triggers identified above are enough to stop symptoms. If your palpitations are short lived and do not make you feel unwell no further action is required. If your palpitations are sustained or occurring frequently or are making you feel unwell this should be investigated further. Similarly if you have a history of heart problems this requires further investigation. You should seek urgent medical attention if your palpitations lead you to black out or if you have severe chest pain or shortness of breath.
Your doctor will take a detailed history and examination and may then arrange for you to have blood tests. You may also be sent for an electrocardiogram (ECG), an ultrasound scan of the heart (echocardiogram) and fitted with an ambulatory ECG monitor. The results of these investigations will determine the next steps and treatment if required.