Heart Palpitations — Causes and When to Worry
Also described as racing heart, fluttering in the chest, skipped beats.
Feeling your heartbeat is common and is often caused by caffeine, stress, fever or anaemia rather than heart disease. Palpitations that come with fainting, chest pain or breathlessness, or that persist at rest, need a cardiology assessment. An ECG during the episode is the single most useful test.
🚨 Get emergency care if you have
- •Palpitations with fainting or near-fainting
- •Palpitations with chest pain or severe breathlessness
- •A racing heart that will not settle after several minutes of rest
- •Palpitations in someone with known heart disease or a family history of sudden death
What causes palpitations?
Atrial fibrillation
An irregular, often rapid rhythm that raises stroke risk and is treatable once identified.
Anaemia
The heart beats faster to compensate for reduced oxygen carriage, with tiredness and pallor.
Thyroid overactivity
A fast pulse with weight loss, tremor, heat intolerance and anxiety.
Caffeine, nicotine or stimulants
Including strong coffee, energy drinks, and some cold and asthma medicines.
Anxiety
A pounding, regular heartbeat with rapid breathing. Diagnosed after rhythm disorders are excluded.
How it is investigated
- ✓ECG, ideally during symptoms
- ✓Holter monitor over 24 hours to 7 days, to catch intermittent rhythms
- ✓Thyroid function and haemoglobin
- ✓2D echocardiogram to check heart structure
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
Are palpitations dangerous?▼
Most are not. Isolated skipped beats in a structurally normal heart are usually harmless. What changes the assessment is fainting, chest pain, breathlessness, a persistently racing pulse, or existing heart disease — any of those warrants prompt cardiology review.
Why do palpitations happen at night?▼
Lying down and a quiet room simply make a normal heartbeat easier to notice, and lying on the left side brings the heart closer to the chest wall. Caffeine late in the day, alcohol and acid reflux also contribute. Persistent nocturnal palpitations still deserve an ECG.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.