When To See A Doctor About Heart Palpitations

Heart palpitations are often considered harmless but could be a sign of something more serious. Learn the difference between normal heart palpitations and arrhythmia, which could require medical intervention.

By URLife Team
21 Nov 2023

Heart palpitations are defined as a rapid, irregular, or abnormal beating of the heart. They can be both a symptom or a separate condition entirely. Heart palpitations can feel like having your heart skip, flutter rapidly or flip flopping in the chest. 

Experiencing heart palpitations can be quite disconcerting, making one acutely aware of their heartbeat—whether it's racing, pounding, or seems irregular. According to a 2021 report by the British Heart Foundation, a normal person’s heart flutters between 60 to 100 beats per minute, but it can vary from minute to minute. However, palpitations disrupt this norm, creating sensations like a racing heart or a skipped beat, often felt in the chest, throat, or neck. 


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Insights and expertise about causes of heart palpitation mentioned here are drawn from an interview published by Apollo Hospitals with Dr. A. Sreenivas Kumar, Sr. consultant cardiologist, Apollo Hospitals, Jubilee Hills, Hyderabad as featured on YouTube. 


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What Causes Heart Palpitations?

According to Dr. A. Sreenivas Kumar, heart palpitations can be due to different causes. "Normally the heart is supposed to beat 70-100 times per minute. If the heart is beating more than 100 per minute, it is called tachycardia and if it beats less than 60 it is called bradycardia. These beatings happen in a systematic manner, which means the gap between two consecutive beats is less than one second. With an irregular heartbeat, the beat-to-beat interval of each heartbeat may differ, usually when the heart begins to flutter faster. It is an abnormal beating which varies with time and is called irregular heartbeat. It is a sign of cardiac arrhythmia.” 

Heart palpitations can stem from a myriad of sources, spanning emotional triggers, medication side effects, and lifestyle choices. While emotions like stress or anxiety can certainly induce palpitations, medications—both prescribed and over-the-counter—can sometimes influence heart rhythm, causing palpitations as a side effect.

Causes of irregular heart beat encompass various cardiovascular and lifestyle factors:

  • High Blood Pressure: Elevated blood pressure can cause the ventricular walls to harden, potentially triggering arrhythmias and increasing the risk of plaque buildup, leading to coronary artery disease (CAD). Common high blood pressure culprits include smoking, stress, physical inactivity, and obesity.
  • Valve Disorders: Even mild to moderate valve abnormalities can provoke symptoms and contribute to heart complications, potentially leading to chest pain alongside arrhythmias.
  • Heart Injuries from Cardiac Events: Reduced blood flow, damage to the heart's electrical system, and stiffening of heart tissues resulting from previous heart attacks can lead to arrhythmias.
  • Coronary Artery Disease: Procedures to address narrowed arterial walls or a history of heart attacks can lead to irregular heart rhythms.
  • Cardiomyopathy: This heart muscle-related condition can prompt arrhythmias, underscoring the importance of ongoing medical guidance to identify the underlying cause.
  • Medical Conditions and Medications: Certain medical conditions (like thyroid disorders, hormonal imbalances, and panic attacks) and specific medications (for conditions such as high blood pressure, psychosis, and depression) can trigger palpitations. Caution should be exercised with over-the-counter medications and antibiotics due to their potential effects on heart rhythm.
  • Long Covid: According to a 2021 study issued in the Journal of Cardiovascular Development And Disease, palpitations have emerged as a prevalent symptom within the spectrum of post-acute sequelae of COVID-19 infection (PASC). Many individuals who have recovered from COVID-19 have reported experiencing a racing heart and an array of symptoms persisting for weeks to months after the initial infection. This lingering effect can cause increased heart rates, especially upon standing or during minimal activity, leading to reduced tolerance for exercise. 
  • Psychological Factors: Stress and anxiety can contribute to irregular heartbeats.
  • Sleep Apnea: This sleep disorder, characterised by erratic breathing patterns during sleep, is associated with arrhythmias.
  • Lifestyle Habits: Excessive smoking, alcohol consumption, and substance abuse can also contribute to irregular heart rhythms.

Moreover, underlying medical conditions, whether related to the heart or other bodily systems, can also contribute to palpitations. Other factors such as thyroid disorders, electrolyte imbalances, fever, or even stimulant use can impact heart rhythm, leading to palpitations.


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Symptoms of Heart Palpitations

If you have a diagnosed heart condition and experience palpitations and if palpitations are accompanied by other concerning symptoms such as:

  • Dizziness
  • Weakness
  • Lightheadedness
  • Fainting or loss of consciousness
  • Confusion
  • Difficulty breathing
  • Excessive sweating
  • Chest pain, pressure, or tightening
  • Pain in the arms, neck, chest, jaw, or upper back
  • Resting pulse rate exceeding 100 beats per minute
  • Shortness of breath

These symptoms, especially when combined with heart palpitations, could indicate a potentially serious condition, warranting immediate medical attention for proper evaluation and necessary intervention.


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When To See A Doctor?

Heart palpitations that pass quickly or happen occasionally might not necessarily require immediate medical attention. However, there are instances when seeking immediate medical help is crucial:

If you're experiencing heart palpitations and:
They persist or worsen with time.
Last longer than a few minutes.
Already have a known heart condition.
There's a history of heart problems in your family.

It's crucial to seek prompt medical attention for a thorough evaluation and appropriate guidance on managing your symptoms.


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The approach to managing palpitations depends on their underlying cause. According to a 2023 study by StatPearls, radiofrequency ablation (a procedure to treat atrial fibrillation) stands as an effective cure for many supraventricular and certain ventricular tachycardias. However, cases related to supraventricular or premature ventricular contractions (PVCs) within a normal sinus rhythm can be more challenging. While these conditions are often considered benign, reassurance is essential for patients. Yet, symptomatic or frequent PVCs exceeding certain thresholds may necessitate treatment.

When PVCs become symptomatic or frequent, initial treatment involves beta-blockers or calcium channel blockers. However, approximately one-third of patients experiencing frequent PVCs may develop PVC-induced cardiomyopathy and progressive left ventricular dysfunction. In such cases, if medical therapy fails or if left ventricular dysfunction develops, catheter ablation for PVCs becomes a consideration. Catheter ablation has shown promise in resolving PVC-induced cardiomyopathy in most patients, particularly those unresponsive to medication.


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While many individuals can manage palpitations without major disruptions, some may benefit from additional support. Talking therapies, such as counselling or cognitive-behavioural therapy, can assist in handling the anxiety or stress that can lead to palpitations. In certain cases, medication might be prescribed to alleviate symptoms if palpitations significantly impact daily life. Various lifestyle adjustments are necessary to stop heart palpitations:

  • Try stress management techniques: Techniques like meditation, deep breathing exercises, yoga, or counselling can help reduce stress, which is a common trigger for palpitations.
  • Consume heart-healthy diet: Avoiding stimulants like caffeine, nicotine, and certain medications, and ensuring a balanced and a heart-healthy diet such as leafy greens, fatty fish, nuts, berries and whole grains can help mitigate palpitations.
  • Do exercise everyday: Maintaining a consistent exercise routine can help manage stress and promote overall heart health, reducing the likelihood of palpitations.
  • Limit alcohol and tobacco consumption: Reducing alcohol intake and quitting smoking can decrease the frequency of palpitations.
  • Manage underlying medical conditions: Treating underlying health issues such as high blood pressure, thyroid disorders, or anxiety can alleviate palpitations associated with these conditions.
  • Try to get adequate sleep: Ensuring proper sleep hygiene and sufficient rest can help reduce the occurrence of palpitations.

If you're feeling concerned or find that palpitations are affecting your quality of life, seeking guidance from your GP is a wise step. They can offer advice, recommend coping strategies, and, if necessary, provide appropriate interventions to help manage and alleviate the impact of palpitations on your daily routine. 


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