What are palpitations?
"Palpitations" is the medical word used to describe the feeling of being aware of your heartbeat. You may be aware of your heart racing, jumping, skipping a beat, bumping or fluttering. Most people who have palpitations do not have a heart problem. Most palpitations are completely normal. A few are abnormal (rarely). The most common cause is anxiety.
You can be aware of your heart beat (experience palpitations) when your heart is working hard (your heart beat is faster or more forceful), for example during or after exercise or when you are anxious, under stress, excited, angry or frightened.
Your heart may also pump faster or harder in response to caffeine contained in many fizzy drinks, tea and coffee. Smoking, nicotine, some sprays and tablets (e.g. nasal decongestants, thyroxine, aminophylline, antidepressants) and lung inhalers can also cause palpitations. When this happens you can become more aware of your heart beating, although it is still beating quite normally. Everyone has an irregular heart beat sometimes. Often there is a pause after one heart beat and then a more forceful beat. Sometimes this forceful beat feels like a thud in your chest. You are most likely to feel this when you are lying resting in bed. This is perfectly normal. We call these extra normal beats or "extrasystoles". Most people who have palpitations are more aware than usual of this normal variation. In this case a heart rhythm "problem" is not present.
Some medical problems, which are not connected with the heart, cause palpitations. Examples are a fever or high temperature, an overactive thyroid gland and anaemia. Your GP will check up if it seems something like that is causing your symptoms - and in any case you get an examination before you are offered a referral for tests.
Rarely, palpitations may be due to an abnormal heart rhythm. This unusual finding is more common in people with other heart problems, for example, a weak or thickened heart muscle, a valve problem or coronary artery disease (angina, heart attack, previous angioplasty or bypass operation).
What should I do if I experience palpitations?
Palpitations that make you feel as though you are going to pass out (or which have made you lose consciousness) may indicate that you have an abnormality of the heart rhythm; this should be investigated quickly. Palpitations that cause you chest pain, tightness or discomfort or unusual breathlessness may also indicate a heart rhythm problem. Make sure you tell you GP or practice nurse or any other doctor you see regularly if any of these have happened to you.