What are heart palpitations?

Palpitations is the feeling of being aware of your heart beating. It can feel like your heart is beating faster or harder than usual. It can sometimes feel like your heart is:

• having extra beats
• missing or skipping beats
• fluttering

Most of the time you don't notice your heartbeat, so it may come as a surprise to suddenly become aware of your heartbeat.

Palpitations are a common symptom and can affect people of all ages.

Palpitations are usually not serious. But always see your doctor if you have palpitations or feel you have an irregular heartbeat.

Call triple zero (000) if you have heart palpitations along with these symptoms:

• shortness of breath
• chest pain or tightness
• dizziness or light-headedness
• fainting or blackouts

What symptoms are related to heart palpitations?

When you have palpitations, you might feel like your heart is:

• racing
• thumping or pounding
• flip-flopping
• fluttering
• skipping beats

You may feel palpitations in your chest or surrounding areas, including your throat or neck. You may be able to hear your heart beating — usually when you are in bed at night.

You might have palpitations when you are:

• sitting or lying still
• bending over
• moving slowly
• exercising

Sometimes palpitations come on when you are feeling stressed or anxious. Palpitations usually come and go.

Other symptoms that can happen with palpitations are:

• feeling faint or fainting
• breathlessness
• chest pain

If you have palpitations with any of these symptoms, call triple zero (000) for an ambulance.

What causes heart palpitations?

There are many causes of palpitations. They can be caused by heart conditions and by other problems.

Heart conditions

Heart conditions that can cause palpitations include:

• heart rhythm problems (arrhythmias), such as atrial fibrillation
• heart failure
• problems with the valves in your heart
• cardiomyopathy
• inherited conditions such as long QT syndrome or Brugada syndrome
• Wolff-Parkinson-White syndrome
• heart attack

Other conditions

Other conditions and problems that can cause palpitations include:

• low blood sugar levels
• anaemia
• an overactive thyroid
• fever
• a salt imbalance in your blood

Mental health and emotions

It's possible to have palpitations when you feel:

• nervous
• anxious, including during a panic attack
• stressed

Medicines and other substances

Palpitations also can happen with:

• caffeine intake, such as from coffee, cola, tea and chocolate
• alcohol and nicotine use
• certain medicines
• recreational drugs, such as cocaine and amphetamines

Palpitations can also happen with exercise.

How is the cause of heart palpitations diagnosed?

Your doctor will talk with you about your palpitations. They will ask:

• how the palpitations start and stop (gradually or suddenly)
• how they feel
• how long they last
• how often they happen
• if anything seems to trigger your palpitations (bring them on or make them worse)
• if anything makes your palpitations better
• about any other symptoms you have

Your doctor will also ask about any heart conditions or other health problems you have, and about your family medical history.

Your doctor will examine you and will recommend tests, such as an electrocardiogram (ECG). This measures your heart's electrical activity.

Other tests may include:

• blood tests
• a Holter monitor — an ECG monitor that you wear continuously for 1 to 2 days while going about your normal activities
• a monitor that you wear for longer periods that records episodes of palpitations
• an echocardiogram — a special ultrasound scan of your heart

Your doctor may recommend referral to a specialist doctor for further tests.

When should I see my doctor?

While there are many causes of heart palpitations that are not serious, it's important to check with your doctor if you have this symptom.

When to seek urgent care

See your doctor urgently if you have:

• heart palpitations that last more than a few minutes
• frequent episodes of heart palpitations
• a family history of heart rhythm problems

Call triple zero (000) for an ambulance if you have heart palpitations along with these symptoms:

• shortness of breath
• chest pain or tightness
• dizziness or light-headedness
• fainting or blackouts

How are heart palpitations treated?

Treatment of heart palpitations depends on:

• what is causing them
• how bad your symptoms are

Self-care at home

There are some things that may help with palpitations that are due to a known, non-serious cause.

• Try sitting down or finding somewhere quiet to rest.
• Try to keep yourself calm and in a comfortable position.
• Try not to panic as this can make your symptoms worse.
• You may find it helpful to loosen any restrictive (tight) clothing, such as your collar button and tie.

Always see your doctor to work out the cause of your palpitations and whether medicines or other treatments are needed.

Medicines and other treatment options

If you have a heart condition like an arrhythmia, your doctor may refer you a specialist. Your doctor may recommend treatment with:

• medicines
• surgery
• an implantable device

Always ask your doctor if you are concerned about your heart palpitations.

Can heart palpitations be prevented?

If you have had heart palpitations, try to avoid anything that brings them on or makes them worse. This includes:

• caffeine
• nicotine
• alcohol
• certain medicines, such as some antihistamines, antibiotics and antidepressants
• recreational drugs

Resources and support

The Heart Foundation has information and support for people with heart conditions, including arrhythmias.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.