Palpitations – an awareness of your own heartbeat, whether that’s a flutter, a thud, or a racing sensation – are one of the most common reasons patients come to see me. Most of the time, they turn out to be harmless. But it’s worth knowing how to tell the difference.
Generally reassuring patterns include: an occasional single skipped beat or flutter, especially after caffeine, alcohol, poor sleep, or stress; palpitations that settle quickly on their own within seconds; and a normal ability to carry on with what you were doing at the time.
Patterns that genuinely warrant a closer look include: palpitations accompanied by chest pain, breathlessness, dizziness, or fainting; episodes that last several minutes or longer; a racing heartbeat that comes on suddenly and stops suddenly, rather than building gradually; and any new palpitations in someone with existing heart disease, or a strong family history of heart rhythm problems or sudden cardiac death.
If you fall into the second group, or you’re simply not sure, it’s worth being seen rather than waiting it out. The investigation is usually straightforward – an ECG in clinic, and often a short period of heart monitoring at home to catch what’s happening during daily life, since palpitations rarely oblige by appearing on demand in the consulting room.
This is general guidance, not a diagnosis for your specific symptoms. If you’re experiencing palpitations alongside chest pain, severe breathlessness, or fainting, please seek urgent medical attention rather than waiting for a routine appointment.