Chest
Palpitations
An unusual awareness of your own heartbeat — feeling it race, pound, flutter or skip — which is most often harmless and triggered by stress, caffeine or exercise, but can sometimes reflect a heart rhythm problem or an overactive thyroid.
Education and reference only. This explains the common causes of palpitations and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is palpitations?
Palpitations are the sensation of being aware of your heart beating, whether it feels too fast, too hard, irregular, or as though it has skipped or added a beat. Everyone's heart speeds up at times, and most palpitations are a normal response to exercise, excitement, anxiety, caffeine, alcohol or lack of sleep, and pass without harm.
- Get urgent help: Call 999 if palpitations come with chest pain, breathlessness or fainting — this needs immediate assessment. Call 999 if you collapse or pass out with a racing heartbeat.
- Self-care: If a doctor has confirmed your palpitations are harmless, you can often reduce them by tackling the common triggers.
About palpitations
Palpitations are the sensation of being aware of your heart beating, whether it feels too fast, too hard, irregular, or as though it has skipped or added a beat. Everyone's heart speeds up at times, and most palpitations are a normal response to exercise, excitement, anxiety, caffeine, alcohol or lack of sleep, and pass without harm. Some, though, come from a genuine disturbance of the heart's rhythm, such as atrial fibrillation, which feels chaotic and irregular, or a sudden burst of very fast, regular beats from the heart's upper chambers. An overactive thyroid can also drive a fast, forceful heartbeat. The key is the company the palpitations keep: those that occur on their own, briefly, and settle quickly are usually benign, whereas palpitations with chest pain, breathlessness, fainting or that simply will not stop need prompt attention.
When to get help
Call 999 or go to A&E if palpitations comes with any of these warning signs:
- Call 999 if palpitations come with chest pain, breathlessness or fainting — this needs immediate assessment.
- Call 999 if you collapse or pass out with a racing heartbeat.
- Seek urgent help for a racing or pounding heartbeat that will not settle on its own.
- Seek urgent help if you have known heart disease and the palpitations feel different from usual or are sustained.
- See a doctor promptly if palpitations are becoming more frequent, are very irregular, or are interfering with daily life.
When to see a doctor
Call 999 straight away if palpitations come with chest pain, severe breathlessness, fainting or collapse. Otherwise, book an appointment if palpitations are new, happen often, last a long time, or come with dizziness or breathlessness, so the rhythm can be checked — sometimes with a heart tracing or a monitor worn for a day or two. People with a known heart condition, or a family history of sudden cardiac problems, should seek advice promptly if their palpitations change in character.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of palpitations
Palpitations has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
If a doctor has confirmed your palpitations are harmless, you can often reduce them by tackling the common triggers. Cutting back on caffeine in coffee, tea and energy drinks, reducing alcohol, and avoiding nicotine all help, as does getting enough sleep and managing stress with relaxation, slow breathing or regular exercise. Keeping a simple diary of when palpitations happen and what you had eaten, drunk or been doing beforehand can reveal a pattern you can then avoid. Stay well hydrated and do not skip meals, as low blood sugar and dehydration can both set palpitations off. These measures are only for palpitations that have already been assessed and found to be benign.
Answers
Palpitations: frequently asked questions
Are palpitations dangerous?
Most palpitations are harmless and caused by things like caffeine, stress, exercise or tiredness. They become a concern when they come with chest pain, breathlessness, dizziness or fainting, will not settle, or occur in someone with known heart disease, when they need prompt assessment.
What triggers palpitations?
Common triggers include caffeine, alcohol, nicotine, stress and anxiety, lack of sleep, dehydration, intense exercise and some medicines. An overactive thyroid and certain heart rhythm problems can also cause them, which is why new or persistent palpitations should be checked.
How are palpitations investigated?
A clinician will ask about your symptoms and may record your heart rhythm with a tracing, or ask you to wear a small monitor for a day or longer to capture an episode. Blood tests, including a thyroid check, are sometimes done to look for an underlying cause.
When should I call 999 for palpitations?
Call 999 if palpitations come with chest pain, severe breathlessness, fainting or collapse, or if a racing heartbeat will not stop. If you have known heart disease and the palpitations feel different or are sustained, treat this as urgent too.
Sources
Where this is drawn from
- NICE CKS: Palpitations.
- British Heart Foundation: palpitations and heart rhythm.
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