When to worry about heart palpitations

Palpitations are something that most of us experience at times. They usually feel like a fluttering or pounding sensation in your chest, as if your heart is racing.

This often passes quickly, but for some people these episodes may last a bit longer. 

If you are having palpitations, it's understandable you may be worried or anxious about them.

But it's important to remember that palpitations are usually harmless and often feel more serious than they are.

Many people live a normal life with palpitations, but some may need help to learn how to live with them. 

When should I get medical help for heart palpitations?

If your palpitations are frequent or prolonged, or you're having symptoms such as chest pain or dizziness too, talk to your GP or call 111 if you're concerned.

They may organise some tests to rule out anything serious, such as an ECG (electrocardiogram) to see if you have a heart rhythm problem.

If needed, they will refer you to a specialist.

What if I have heart palpitations but a normal ECG?

If you do not experience palpitations during an ECG they might not show up on the test.

If this happens, your doctor may suggest you wear a Holter-monitor (a continuous ECG) so they can look at your heart rhythm over a longer period. Your doctor or nurse will discuss this with you if it's something they recommend.

But for many people, no underlying cause for their palpitations is ever found, and they learn to live with them.

Why do I get heart palpitations after eating?

Heart palpitations are common after eating. Foods high in sugar, carbohydrates or salt can trigger palpitations, and you may find eating smaller meals helps.

Caffeine is also known to cause palpitations, so cutting down on tea, coffee and chocolate may be worthwhile.

Alcohol is another trigger and you may wish to stop or cut down the amount you drink.

You may feel your palpitations more at night, but usually this is just because you are less distracted and more aware of your body.

Should heart palpitations stop me exercising?

You may notice palpitations when you exercise – if they are putting you off being active, then get them checked out.

If you've seen your doctor and you do not need further investigation or treatment, then exercising as part of a healthy lifestyle is recommended.

If exercise is new to you, start with 5 or 10 minutes of walking and gradually increase your time and distance.

As long as you increase your activity level gradually, you should be able to get used to more intense exercise.

Be cautious and speak to your doctor about any new symptoms so you can be monitored if needed.

Can anxiety cause heart palpitations?

Yes, anxiety can make your heart race and we also know that palpitations themselves can trigger feelings of anxiety.

There are different methods you can try to reduce anxiety, including grounding and relaxation techniques.

Talking therapies can also help with anxiety, and sometimes medicine is prescribed for anxiety linked to palpitations if it's stopping you from living a normal life.

Can medicines cause heart palpitations?

Yes, some medicines are known to cause palpitations in some people, including:

• Cold and flu medicines containing decongestants.
• Some antibiotics, such as azithromycin and ciprofloxacin.
• Some antidepressants, such as some serotonin-norepinephrine reuptake inhibitors (SNRIs).
• Some asthma inhalers, such as beta-agonists.
• Thyroid medicine levothyroxine.
• Painkillers with added caffeine.
• ADHD medicines. 

Always mention any new palpitations to your doctor or pharmacist.

Changing the dose or formula of your medicine may help. Otherwise, you can discuss switching to a different medicine.

6 tips for managing heart palpitations

1. If food triggers your palpitations, try eating smaller meals and avoiding spicy foods.
2. If caffeine or alcohol trigger your palpitations, try cutting down or stop drinking them all together.
3. If your palpitations are linked to anxiety, try talking therapies or speak to your doctor about anti-anxiety medicines.
4. If your palpitations make you feel anxious, try breathing and relaxation techniques and talk to your doctor for other support.
5. If medicines cause your palpitations, speak to your doctor as they may be able to change the dose or trial a different medicine.
6. Try exercise to help ease palpitations as part of a healthy lifestyle. But check with your doctor first and if your palpitations get worse with exercise, stop and speak to your doctor.

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