What are heart palpitations?

Heart palpitations are the feeling of being aware of your heartbeat. You may notice your heart beating faster or harder than usual. You may feel palpitations in your chest or nearby areas, such as your neck.

It may sometimes feel like your heart is:

• pounding
• sinking
• missing or skipping beats
• fast and fluttering

Most of the time, you do not notice your heartbeat. This is why heart palpitations may feel sudden or worrying when they happen. Heart palpitations usually come and go.

Heart palpitations are a common symptom and may affect people of all ages. They are usually not serious, but it is important to see your doctor if you have palpitations.

What causes heart palpitations?

There are many causes of heart palpitations. They may be caused by heart conditions or other health problems.

You may notice palpitations more when you:

• exercise
• feel unwell
• feel anxious

Heart conditions

Heart conditions that may cause palpitations include:

• heart rhythm differences, known as arrhythmias — such as'atrial fibrillation
• heart failure — where your heart doesn't pump blood as well as it should
• cardiomyopathy — a condition that affects your heart muscle
• inherited conditions — such as'long QT syndrome'or'Brugada syndrome
• Wolff-Parkinson-White syndrome — a condition that causes a fast heartbeat
• heart valve problems
• heart attack

Other conditions

Other conditions and health differences that may cause palpitations include:

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

Mental health and emotions

You may have palpitations when you feel:

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

Medicines and other substances

Palpitations may also happen with:

• caffeine, such as from coffee, cola, tea and chocolate
• alcohol'
• nicotine
• certain medicines
• illicit drugs, such as'cocaine'and'amphetamines

Medicines used to treat attention deficit hyperactivity disorder (ADHD) and asthma reliever inhalers may cause palpitations. Speak with your doctor if you think a medicine may be affecting you.

When should I see my doctor?

You should see your doctor if you notice heart palpitations so your heart can be checked.

When to seek urgent care

See your doctor urgently if you have:

• heart palpitations that last more than a few minutes
• palpitations that happen often
• heart palpitations and a family health history of heart rhythm problems

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

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

How is the cause of heart palpitations diagnosed?

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

• how they feel
• how long they last
• how often they happen
• what triggers them or makes them worse
• what helps them settle
• about any other symptoms you may have
• about your and your family's medical history

Your doctor may do a physical examination and may suggest tests, such as an'electrocardiogram (ECG). This measures your heart's electrical activity.

You may also need tests, including:

• blood tests
• ultrasound scan of your heart
• chest x-ray
• coronary angiogram
• Holter monitor — an ECG monitor worn for 1 to 2 days
• continuous loop event monitor — worn for longer periods
• implantable loop recorder (ILR) — a small device placed beneath the skin of your upper chest

Your doctor may also refer you to a cardiologist or other specialists for more tests.

How are heart palpitations treated?

Treatment depends on what is causing your palpitations and how much they affect you.

Self-care at home

If your palpitations are caused by a known, non-serious reason, these tips may help you:

• Sit down and rest in a quiet place.
• Try to stay calm and comfortable.
• Try not to panic. This can make your symptoms worse.
• Loosen tight clothing, such as your collar or tie.

Always see your doctor to work out the cause of your palpitations and to check if treatment is needed.

Medicines and other treatment options

If you have a heart condition such as an arrhythmia, your doctor may refer you to a specialist. Together, you may discuss treatment options such as:

• medicines
• surgery
• an implantable device

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

Living with heart palpitations

Many people live well with heart palpitations, especially when the cause is not serious.

Here are tips that may help settle heart palpitations:

• Keep track of when palpitations happen and what triggers them.
• Manage stress.
• Get enough sleep.
• Limit caffeine and alcohol.
• Quit smoking.
• Avoid illicit drugs.

Always follow your doctor's advice and attend regular check-ups if suggested.

What are the complications of heart palpitations?

Most heart palpitations do not lead to complications.

If your heart palpitations are caused by an underlying heart condition, complications may include:

• fainting
• falls
• an increased chance of stroke or heart failure

Can heart palpitations be prevented?

Heart palpitations can't be prevented. If you have had heart palpitations, try to avoid any triggers that bring them on or make them worse.

Resources and support

The Victor Chang Cardiac Research Institute has information about heart palpitations.

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

The Government of Western Australia Department of Health has information on abnormal heart rhythms.

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 you 24 hours a day, 7 days a week.

Other languages

Read about heart health in your language at the Heart Foundation.

The Heart Foundation also has'a video about the warning signs of a heart attack in several community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Heart Foundation has resources about heart disease and how to look after your heart for Aboriginal and/or Torres Strait Islander peoples.

St Vincent's Hospital Heart Health has further information for Aboriginal and/or Torres Strait Islander peoples.

The Institute for Urban Indigenous Health offers heart rehabilitation ('rehab'). This is a supportive and friendly group environment to yarn about your health.