Heart Palpitations

You should contact your GP if:

• The palpitations last a long time, do not improve, or get worse
• You have a history of heart problems
• You’re concerned about the palpitations
• You experience recurrent palpitations brought on by exercise

You should seek emergency medical assessment by 999 ambulance or attend A&E if you are experiencing palpitations accompanied by any of the following symptoms:

• Severe shortness of breath
• Chest pain or tightness
• Dizziness or light-headedness
• Fainting or blackouts

These symptoms could indicate a serious or potentially life-threatening heart problem that should be checked by a doctor straight away.

The causes of heart palpitations include:

• lifestyle triggers
• emotional triggers
• medication
• hormone changes
• heart rhythm problems
• structural heart conditions
• other medical conditions

Lifestyle triggers

Common lifestyle triggers of heart palpitations include:

• strenuous exercise
• drinks containing caffeine, such as coffee, tea, and energy drinks
• alcohol
• smoking
• illegal drugs, such as cocaine, heroin, amphetamines, ecstasy, and cannabis
• rich or spicy foods

In these cases, the palpitations should go away on their own and avoiding these triggers may help stop them from coming back.

To get help with any of the above issues regarding health, lifestyle, and wellbeing and to access local services near you click here.

Emotional Triggers

Heart palpitations are also often caused by emotions or psychological issues, such as:

• excitement or nervousness
• stress or anxiety
• panic attacks – an overwhelming sense of anxiety or fear, accompanied by feeling sick, sweating, trembling and palpitations

Doing breathing exercises and learning how to deal with a panic attack may help if you’re feeling stressed, anxious, or panicked.

To access mental health support near you, click here.

Medication

Occasionally, palpitations can be a side effect of some types of medicine, such as asthma inhalers or tablets for a thyroid problem. This may be particularly noticeable if you have just started taking the medication.

Speak to your GP if you think medication may be responsible for your palpitations. Usually, you shouldn’t stop taking a prescribed medication without consulting your GP first.

Hormone Changes

Sometimes the hormone changes that happen during a woman’s period, during pregnancy or around the menopause can cause palpitations.

These may only be temporary and are usually nothing to worry about.

Heart rhythm problems

Palpitations are sometimes caused by a problem with the heart rhythm (arrhythmia), such as:

• atrial fibrillation – this is the most common type, where the heart beats irregularly and faster than normal
• atrial flutter – a fast and irregular heartbeat
• supraventricular tachycardia (SVT) – abnormally fast heart rate
• ventricular tachycardia – a more serious condition where the regular heartbeat is typically fast. It can be associated with dizziness or blackouts

If your GP suspects an arrhythmia, then they will arrange for you to have an electrocardiogram (ECG) to assess your heart rate and rhythm. This may confirm whether there is a problem, and whether treatment is needed. However, often the ECG is entirely normal especially if you aren’t having palpitations when it is being taken. Further tests may then be needed, which can be done by your GP or by your local hospital.

Structural Heart conditions

Sometimes palpitations may be associated with an abnormality in the structure of the heart, such as:

• a problem with the heart valves, such as mitral valve prolapse
• hypertrophic cardiomyopathy – where the heart muscle and walls of the heart become enlarged and thickened
• heart failure – where the heart is unable to pump blood around the body properly
• congenital heart disease – birth defects that affect the normal workings of the heart

Some of these conditions can be serious and require treatment.

Other medical conditions

There several other medical conditions can make the heartbeat faster, stronger, or more irregularly and so can be a cause of heart palpitations.

These include:

• An overactive thyroid (hyperthyroidism)
• A low blood sugar level (hypoglycaemia) – this is most commonly associated with diabetes
• Anaemia (low red blood count)
• Postural or orthostatic hypotension – dizziness and low blood pressure triggered by changing position (such as standing up)
• Infections
• Dehydration (not enough fluid in the body)

If you have an episode of palpitations, it can be useful to check your pulse. It is helpful for your doctor to know how fast your pulse was during the episode. That is, how many beats per minute; also, if your pulse felt regular or irregular. This information can help identify the cause of the palpitations. You can learn how to take your own pulse on the British Heart Foundation website.

To help find the cause for your palpitations your GP may:

• ask about your symptoms and medical history
• arrange a blood test to exclude any of the medical causes referred to above
• carry out an electrocardiogram (ECG) to check your heart rate and electrical activity (if the GP has the equipment available)
• arrange for a routine chest x-ray (CXR) to see if there is any enlargement of the heart or signs of associated lung problems
• arrange for an ultrasound of your heart (echocardiogram) to look at the structure of your heart in more detail

If you cannot have an ECG at the GP surgery or if your GP wants to arrange heart monitoring over a longer period of time, you may be referred for tests at a local hospital.

As palpitations are usually harmless; they often don’t require treatment.

However, if you do require treatment, the type of treatment will depend upon the specific cause of your palpitations.

If, for example, your palpitations are caused by drinking too much caffeine, you will be advised to cut down how much caffeine you drink.

If your palpitations are caused by anxiety, your GP will discuss ways of managing this.

If you’re diagnosed with an arrhythmia, your doctor might prescribe medication such as beta blockers to regulate your heart rate and rhythm.

Many cases of palpitations can be managed by your GP; but in some cases, you may need to be referred to a heart specialist (cardiologist).

If you have been referred for a specialist opinion your details will be reviewed and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will I wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.

• Waiting times
• Find services near you