Palpitations: When Should You See a Cardiologist?

Palpitations are a common symptom and are often described as an awareness of the heartbeat. Some people notice a rapid heartbeat, while others describe a pounding, fluttering, or irregular sensation in the chest.

In many cases palpitations are harmless and may be related to stress, caffeine, or fatigue. However, they can occasionally be caused by an abnormal heart rhythm (arrhythmia), which is why persistent or troubling symptoms may benefit from medical assessment.

What Do Palpitations Feel Like?

People experience palpitations in different ways. Common descriptions include:

• A racing heartbeat

• A fluttering sensation in the chest

• The feeling that the heart is skipping beats

• A strong or pounding heartbeat

• Brief episodes of irregular rhythm

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These sensations may last only a few seconds or continue for several minutes.

Common Causes of Palpitations

There are many potential causes of palpitations. The most frequent include:

Stress and anxiety

Emotional stress or anxiety can stimulate the body's adrenaline response, leading to a faster or more noticeable heartbeat.

Caffeine and stimulants

Coffee, energy drinks, and certain medications can trigger palpitations in sensitive individuals.

Fatigue or dehydration

Lack of sleep or dehydration can make the heart rhythm more noticeable.

Benign extra heartbeats

Many people experience occasional extra beats known as ectopic beats. These are usually harmless.

Heart rhythm disorders (arrhythmias)

Less commonly, palpitations may be caused by an abnormal heart rhythm such as atrial fibrillation or supraventricular tachycardia.

Symptoms That May Suggest a Heart Rhythm Problem

Although many palpitations are harmless, certain symptoms should prompt medical assessment.

These include:

• Palpitations associated with dizziness or lightheadedness

• Episodes lasting several minutes or longer

• A very rapid heartbeat that begins suddenly

• Palpitations associated with chest discomfort or breathlessness

• Episodes that occur during exercise

• A history of heart disease

  
  

If palpitations are associated with collapse or severe symptoms, urgent medical attention should be sought.

How a Cardiologist Investigates Palpitations

Assessment usually begins with a discussion about your symptoms and medical history.

Depending on the pattern of palpitations, tests may include:

Electrocardiogram (ECG)

A quick test that records the electrical activity of the heart.

Ambulatory heart rhythm monitoring

Portable monitors worn for 24 hours or longer can capture intermittent rhythm disturbances.

Echocardiogram

An ultrasound scan that assesses heart structure and function.

Cardiac MRI or CT scan

In some cases, advanced imaging may be used to assess the heart in more detail.

These investigations help determine whether symptoms are caused by a benign rhythm disturbance or a more significant arrhythmia.

Reassurance for Many Patients

The majority of people who experience palpitations have normal heart structure and a benign rhythm disturbance. Identifying this can be very reassuring and allows symptoms to be managed with simple measures such as reducing caffeine intake, improving sleep, or managing stress.

In some cases, treatment may be recommended if a specific rhythm disorder is identified.

When Should You Seek Assessment?

You may wish to consider cardiology assessment if:

• Palpitations are frequent or persistent

• Episodes are affecting your quality of life

• Symptoms occur during exercise

• There is a family history of heart rhythm problems

• You would like reassurance that your heart is healthy

  
  

Early evaluation can help clarify the cause of symptoms and provide reassurance where appropriate.

Book an Appointment

If you are experiencing palpitations or have concerns about your heart rhythm, you can arrange a consultation to discuss your symptoms and whether any investigations are necessary.

Appointments are available at Spire Murrayfield Hospital and most patients can be seen promptly.