Palpitations are when you suddenly notice your own heartbeat. It may race, pound, flutter or skip, and you may feel it in your chest, neck or throat. Most episodes are harmless. One that will not settle, or arrives with chest pain, breathlessness or a faint, needs 999 or A&E. Dr Navin Chandra, consultant cardiologist, looks for the cause in clinics in Ascot, Slough, Windsor and Wexham.
| Question | Answer |
|---|---|
| Common symptoms | A racing, pounding, fluttering or skipping heartbeat, lasting seconds, minutes or longer |
| How it’s diagnosed | Your history, an examination, an ECG and sometimes a heart monitor or blood tests |
| Treatment options | Often none is needed. Cutting down on triggers helps, and any rhythm problem found is treated |
| When to seek urgent help | Call 999 or go to A&E if it will not stop, or comes with chest pain, breathlessness or fainting |
What Are Palpitations?
A palpitation is a heartbeat you can feel when you would not normally notice it. The NHS advice on this symptom describes four common sensations. The heart may race, beat irregularly with skipped or extra beats, pound or thump, or flutter.
Most episodes pass on their own and do no harm. Sometimes they point to a heart rhythm problem. Examples include atrial fibrillation, supraventricular tachycardia (SVT), ectopic beats and Wolff-Parkinson-White syndrome. How those are treated is explained under heart rhythm management.
Common Triggers, Causes and Risk Factors
Everyday triggers are behind most episodes. The NHS and the British Heart Foundation both list:
- Exercise and sleep: a hard workout or too little sleep.
- Worry and stress: anxiety, or a panic attack.
- Things you take: caffeine, alcohol, nicotine, vaping, recreational drugs and some medicines, prescribed or bought over the counter.
- Food: spicy or rich meals, for some people.
- Hormone changes: the menopause and pregnancy.
- Conditions outside the heart: iron deficiency anaemia and an overactive thyroid.
- Heart conditions: a rhythm problem, heart valve disease, cardiomyopathy or heart failure.
Relatives with heart disease, or a heart diagnosis of your own, make a check more worthwhile. A normal resting heart rate is 60 to 100 beats per minute, so a pulse well above that at rest is worth recording.
Symptoms: Racing, Fluttering, Pounding or Skipped Beats
An episode can last a few seconds, several minutes or longer. People often describe:
- A sudden racing heartbeat that starts and stops abruptly
- A skipped or extra beat, sometimes followed by a thump
- A pounding feeling in the chest or neck
- A flutter after coffee, alcohol or a stressful day
- A fast heartbeat with light-headedness
| Red-flag symptom | Go to |
|---|---|
| Palpitations happening now that do not go away | 999 or A&E |
| A racing or irregular heartbeat with chest pain | 999 or A&E |
| A racing or irregular heartbeat with shortness of breath | 999 or A&E |
| A racing or irregular heartbeat with feeling faint, or fainting | 999 or A&E |
| Any of the above that has now stopped | Urgent GP appointment, NHS 111 or 111 online |
| Episodes that keep coming back, last more than a few minutes, or happen with a heart condition or family history | Your GP |
Please do not drive to A&E yourself. Someone else can take you, or an ambulance can come. Carry your usual medicines with you.
Ectopic Beats: The Extra Beat Most People Feel at Some Point
An ectopic beat is an early or extra heartbeat. It can feel as though the heart has paused, or given one hard knock. Dr Chandra’s patient information notes that nearly everyone has them at some point.
The British Heart Foundation notes that a noticeable heartbeat can come at any time, even at rest. Like other palpitations, extra beats often need no treatment once a heart cause is ruled out.
Extra beats still deserve a check if they become frequent or come with dizziness or a faint. The same goes for anyone with a known heart condition. A heart monitor can show how often they happen and whether anything else is going on.
When to See a Specialist About a Racing Heart
See your GP, or arrange a specialist assessment, if any of these apply:
- episodes keep coming back or are getting more frequent
- an episode lasts longer than a few minutes
- you have a heart condition, or heart problems run in your family
- a racing heart has made you light-headed or caused a blackout
- a relative died suddenly when younger than 40 years, or has an inherited heart condition
- you have AF or another rhythm problem and treatment is not controlling it
NICE treats a family history of sudden cardiac death under 40 as a red flag in anyone who has blacked out. Your GP can refer you, or you can contact the practice directly.
How Palpitations Are Diagnosed in Clinic
Diagnosis starts with your own account. Dr Chandra asks how the heartbeat feels, how long each spell lasts and what seems to start it. Tapping out the rhythm on a table often helps. He then examines you and records an ECG, a short tracing of the heart’s electrical signals.
Blood tests can look for an overactive thyroid or anaemia. An echocardiogram (a heart ultrasound) checks its structure when needed through cardiac imaging.
A normal clinic ECG does not end the search. A portable recorder then captures your rhythm through daily life, chosen by how often episodes happen. The heart rhythm page compares each monitor.
Treatment Options When a Rhythm Problem Is Found
What happens next depends on the cause.
Reassurance and No Treatment
Often no treatment is needed after tests find nothing wrong with the heart. A normal recording is useful in itself.
Cutting Down on Triggers
Less caffeine and alcohol, not smoking, better sleep and managing stress can help when no health condition lies behind the episodes.
Medicines or a Procedure for the Heartbeat
If a heart problem is the cause, medicines or a procedure may help control your heartbeat. Dr Chandra talks you through each choice and its risks.
Treating a Cause Outside the Heart
Where an overactive thyroid or anaemia is to blame, that condition is treated, often by your GP. Episodes can ease once it is under control.
Living With an Unpredictable Heartbeat: Outlook and Self-Care
When tests find no heart cause, the NHS describes these episodes as usually harmless. They may still come and go. A few habits can make them less frequent:
- Keep a symptom diary with the date, time, activity and how long each episode lasted
- Cut down on caffeinated drinks, and stay within 14 alcohol units across the week
- Stop smoking or vaping
- Protect your sleep and make time to unwind
During an episode, sit down and note the time it started. Call 999 if chest pain, breathlessness or faintness join in. For episodes during sport, sports cardiology covers how athletes are assessed.
Why See Dr Chandra About Palpitations?
- Consultant care: NHS consultant cardiologist at Frimley Health NHS Foundation Trust, with an honorary post at Royal Brompton and Harefield.
- Monitoring to suit you: from a one-day recorder to an implantable loop recorder.
- Clear next steps: if a rhythm problem needs treating, he treats it or refers you to a specialist centre for ablation.
- Research interest: inherited cardiac conditions, which matters when there is a family history.
Where to Book an Assessment With Dr Chandra
Appointments run at four hospitals, face to face or by video.
| Hospital | Address |
|---|---|
| The Parkside Suite, Heatherwood Hospital | Brook Ave, Ascot SL5 7GB |
| The Parkside Suite, Wexham Park Hospital | Wexham, Slough, Berkshire SL2 4HL |
| BMI Princess Margaret Hospital | Osborne Road, Windsor, Berkshire SL4 3SJ |
| Spire Thames Valley Hospital | Wexham Street, Wexham, Buckinghamshire SL3 6NH |
To ask about clinic days, phone 020 7099 9685 or email enquiries@navinchandra.co.uk with your question. If you need advice out of hours, NHS 111 can help. Emergencies need 999.
Palpitations Consultation Fees and Insurance
| Appointment | Fee |
|---|---|
| Consultation | Quoted when you book |
| ECG | Quoted when you book |
| Heart monitor | Quoted separately |
No prices appear online. Each price for 2026 is set out at booking. Paying for yourself is fine, as is private health insurance through providers such as Bupa, AXA Health, Vitality or Aviva. Confirm cover with your insurer before the visit.
FAQs About Palpitations
Should I worry about a pounding heartbeat?
Usually not. Most episodes do no harm. If one refuses to settle or brings chest pain, breathlessness or a faint, call 999 or go to A&E. See your GP if they keep returning.
How long can palpitations last?
Seconds, minutes or sometimes longer. Short episodes that settle are common. One lasting more than a few minutes is worth a GP visit, and one that will not stop needs urgent help.
Why do I notice my heartbeat more when lying down?
Some people feel it most when lying down at night, and it can happen at rest. Often no heart cause is found. If it happens most nights, or you feel unwell, ask for a check.
Can anxiety cause a racing heart?
Yes. Feeling stressed or anxious often sets one off, and so can a panic attack. A heart cause should still be ruled out, especially if the episodes are new. Normal results can be reassuring.
Is a palpitation the same as atrial fibrillation?
No. A palpitation is a feeling, while AF is one possible cause of it. AF is an irregular rhythm from the upper chambers. An ECG taken during symptoms shows which you have.
Can the menopause cause palpitations?
Yes. Hormone changes around the menopause are on the NHS list of triggers, and pregnancy can bring them on too. Mention them to your GP, because thyroid problems and anaemia can feel similar.
Can caffeine trigger a fast heartbeat?
Yes, caffeine is a common trigger. Cutting down on caffeinated drinks, and noting what happens in a diary, shows whether it is yours. If episodes carry on, other causes should be checked.
Book a Palpitations Consultation with Dr Navin Chandra
- Phone: 020 7099 9685
- Email: enquiries@navinchandra.co.uk
- Online: use the booking page, or send a question through the contact page
Chest pain, breathlessness or a faint alongside a racing heart is a 999 call, not a reason to book. Related pages cover chest pain, dizziness and blackouts and other heart symptoms.