Palpitations are a common reason for seeking cardiology advice. They are usually described as a sensation of the heart racing, fluttering, or skipping beats.

In many cases palpitations are harmless, but they can sometimes be caused by an abnormal heart rhythm (arrhythmia). A cardiology assessment can help determine whether symptoms are related to the heart and whether further investigation is required.

​

Possible causes of palpitations

​

Palpitations may be caused by several factors including:

​

• Benign ectopic beats (extra heartbeats)
• Supraventricular tachycardia (SVT)
• Atrial fibrillation or atrial flutter
• Stress or anxiety
• Caffeine or stimulant intake
• Thyroid disorders

​

Many people with palpitations have structurally normal hearts, but identifying the underlying rhythm is important to guide appropriate management.

​

When to seek medical advice

​

You should consider cardiology assessment if you experience:

​

• recurrent or persistent palpitations
• episodes of rapid or irregular heartbeat
• palpitations associated with dizziness or lightheadedness
• palpitations occurring during exercise
• symptoms with a family history of heart rhythm disorders

​

Urgent medical attention should be sought if palpitations are associated with chest pain, blackout, or severe breathlessness.

​

How palpitations are investigated

​

Assessment may include:

​

• ECG
• Ambulatory heart rhythm monitoring (Holter monitor or patch monitor)
• Echocardiogram
• Exercise testing
• Blood tests where appropriate

​

Heart rhythm monitoring is often the most useful test, as it allows the heart rhythm to be recorded during symptoms.

​

What happens during your consultation

​

During your appointment, a detailed history of the episodes will be taken and your cardiovascular risk assessed.

​

Where appropriate, investigations can be arranged promptly to clarify the underlying rhythm disturbance and guide treatment.