In this article 6 sections
You may be sitting quietly when your heart suddenly feels as though it is racing, pounding or missing a beat. These sensations are called palpitations. Some people notice them in the chest, while others feel them in the throat or neck.
Palpitations describe what you feel, rather than a diagnosis. They can happen with a normal heart rhythm or with a rhythm problem. Many are harmless, but new or changing symptoms deserve attention.
When to get emergency help
Palpitations with chest pain, shortness of breath, fainting or feeling close to fainting need emergency help. In India, call 112 and do not drive yourself to hospital. Do not wait to see whether breathing exercises or rest will make these symptoms disappear.
Persistent palpitations that do not settle also need urgent assessment. If an episode with warning symptoms has stopped, contact a doctor urgently rather than assuming that the problem has passed.
What can bring on palpitations?
Stress, caffeine, dehydration and certain medicines can affect the heartbeat. Some people notice a connection with alcohol, smoking or products taken for a cold or allergy. A possible trigger is useful information for your doctor, but it does not establish the cause by itself.
Palpitations can also occur during pregnancy or around menopause. Other possible causes include iron deficiency anaemia, an overactive thyroid, heart valve disease or a heart rhythm problem. This is why repeated episodes should not automatically be put down to anxiety or hormonal changes.
When should you book a doctor’s appointment?
Arrange an appointment if palpitations keep returning, happen more often or last longer than a few minutes, even if you otherwise feel well. Tell your doctor if you already have a heart condition or if heart problems run in your family.
A change in a familiar pattern matters too. Episodes that become longer, more frequent or different from usual should be reassessed rather than managed on the assumption that the previous explanation still applies.
Which tests might your doctor recommend?
Your doctor will ask about the episodes, examine you and review your medicines and medical history. An ECG records the heart’s electrical activity and is commonly used to look for rhythm problems. Blood tests may check thyroid function and levels of minerals, such as potassium, that help the heart work normally.
Because some rhythm problems come and go, a short ECG may not capture an episode. Your doctor may recommend a Holter monitor or another device that records your heartbeat for longer while you continue normal activities. The choice depends partly on how often symptoms occur and what the initial assessment shows.
What should you record before the appointment?
Note when an episode starts, how long it lasts and what you were doing beforehand. Describe whether it feels fast, irregular, fluttering or unusually forceful, and whether it begins and ends suddenly. Include other symptoms, such as dizziness or breathlessness.
Bring your medicine list and mention caffeine, alcohol and any cold remedies or supplements you use. These details can help your doctor decide what needs checking. Recording an episode should never delay getting emergency help.
How are palpitations treated?
Treatment depends on the cause. If a thyroid problem, another medical condition or a medicine is contributing, your doctor will address that. If an abnormal heart rhythm is identified, treatment may involve medicines or a procedure, depending on the type of rhythm problem and its effect on your health.
Do not start a medicine to slow your heartbeat or change an existing dose without your doctor’s advice. Medicines used for rhythm problems need careful selection because an unsuitable medicine or dose can sometimes make the problem worse.
Once your doctor has assessed the cause, discuss any triggers you can reasonably avoid and whether further monitoring is needed. Ask what to do if another episode occurs, which symptoms require urgent help and when to return for review. Having a clear plan makes it easier to respond without dismissing symptoms or becoming alarmed by every change.