Heart palpitations

Heart palpitations are heartbeats that suddenly become more noticeable.

Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. You may also feel these sensations in your throat or neck.

Palpitations may seem alarming, but in most cases they're harmless and are not a sign of a problem with your heart.

However, palpitations accompanied by other symptoms, such as dizziness or tightness in your chest, can sometimes be a sign of a heart problem (see below).

You should visit your GP if you have palpitations along with other symptoms or if you're concerned.

What causes heart palpitations?

Lifestyle triggers

Palpitations may be triggered by a surge of adrenaline, a hormone your body releases after you have overexerted yourself or when you feel nervous, anxious or excited.

Eating rich, spicy foods, drinking excessive amounts of caffeine or alcohol, smoking, and using recreational drugs can all bring on palpitations.

If you think lifestyle factors are causing your palpitations, try to reduce your stress levels by using relaxation techniques and moderating the level of exercise you do.

You should also reduce your intake of coffee or energy drinks and avoid using recreational drugs.

Panic attacks

If you have regular palpitations and also have feelings of anxiety, stress and panic, you may be experiencing panic attacks.

A panic attack can cause an overwhelming sense of anxiety, fear and apprehension, accompanied by nausea, sweating, trembling and palpitations.

Panic attacks can be frightening and intense, but aren't usually dangerous. Read more about panic attacks.

Medication

Less commonly, palpitations can be a side effect of some types of medicine, such as asthma inhalers or tablets for a thyroid problem.

Speak to your GP if you think medication may be responsible for your palpitations. Don't stop taking a prescribed treatment without first consulting your GP.

Periods, pregnancy and the menopause

Palpitations can sometimes be the result of hormonal changes during a woman's periods, during pregnancy, or around the time of the menopause. However, these are usually only temporary and not a cause for concern.

Medical conditions

The following conditions can make the heart beat faster, stronger or irregularly, and can be a cause of heart palpitations:

• an overactive thyroid
• a low blood sugar level
• anaemia
• some types of low blood pressure 
• a high temperature (fever) of 38C (100.4F) or above 
• dehydration (not enough fluid in the body)
• a heart problem (see below)

When you may have a heart problem

If you start to experience palpitations more often, or if they get worse or occur with other symptoms such as dizziness or tightness in your chest, see your GP. You may have a heart rhythm problem (arrhythmia), such as atrial fibrillation or supraventricular tachycardia (SVT).

There are also other, less common, heart rhythm conditions that may be the cause of your palpitations. These can be determined by appropriate tests. When your GP or hospital discovers the exact problem with your heart, ask them to explain it to you.

Seeing your GP

Your GP will often carry out an electrocardiogram (ECG) to assess your heart rate and rhythm. This may immediately confirm whether there's a problem and whether treatment is needed.

However, the results of an ECG will often be completely normal if you're not having palpitations at the time of the test. Further tests may be needed, which may be carried out by your GP or local hospital.

Atrial fibrillation

Atrial fibrillation is one of the most common heart rhythm problems and is a major cause of stroke (a serious medical condition that can cause permanent disability).

In the UK, atrial fibrillation affects up to 800,000 people, and is most common in those over 55 years of age. It causes a fast, irregular pulse, which can cause a persistent heart flutter.

You may also feel dizzy, short of breath and very tired. Atrial fibrillation is not usually life threatening, but can be uncomfortable and often needs treating.

Supraventricular tachycardia (SVT)

Supraventricular tachycardia (SVT) is a similar heart rhythm problem to atrial fibrillation. It also causes episodes of an abnormally fast heart rate, but the heart rate is often steady and not irregular.

Episodes of SVT are usually harmless and tend to settle down on their own without the need for treatment. However, you should seek medical advice if you have prolonged episodes of SVT.