Heart palpitations can make you suddenly aware of your heartbeat. Your heart may feel as though it is racing, fluttering, pounding, or skipping beats. These sensations are often harmless and may follow stress, caffeine, exercise, or a lack of sleep. In some cases, however, palpitations can be linked to an abnormal heart rhythm or another medical condition.
What Do Heart Palpitations Feel Like?
Heart palpitations are sensations that make your heartbeat feel unusually noticeable. You may feel them in your chest, throat, or neck. They can happen while you are active, sitting quietly, lying in bed, or trying to fall asleep.
People describe heart palpitations in different ways, including:
A racing heartbeat
Fluttering in the chest
A pounding or thumping sensation
A heartbeat that feels unusually strong
Skipped or missed beats
Extra beats
An irregular rhythm
A sudden pause followed by a forceful beat
A quivering sensation in the chest
Palpitations may last for a few seconds, several minutes, or longer. Some occur once and disappear, while others return throughout the day or happen regularly over several weeks.
Feeling a skipped beat does not always mean that the heart has stopped. An early beat may be followed by a short pause, making the next normal heartbeat feel stronger. These are sometimes called premature or ectopic beats and are common in many healthy people.
The sensation can still be frightening, particularly when it happens for the first time. The way a palpitation feels does not always reveal its cause, so the surrounding circumstances and associated symptoms are important.
Common Triggers That Are Often Harmless
Many episodes of heart palpitations are caused by temporary changes in the body rather than heart disease. A normal heart may beat faster or more forcefully in response to physical activity, emotion, stimulants, or hormonal changes.
Common triggers include:
Stress or anxiety
Panic attacks
Intense exercise
Lack of sleep
Dehydration
Fever
Pain
Caffeine
Energy drinks
Nicotine
Alcohol
Recreational drugs
Large or rich meals
Sudden fright or excitement
Pregnancy
Menopause
Menstruation
Caffeine affects people differently. One person may drink several cups of coffee without symptoms, while another may experience palpitations after one strong cup. Energy drinks can be particularly stimulating because they may contain large amounts of caffeine, sugar, and other stimulant ingredients.
Alcohol can trigger palpitations during drinking or several hours later. Heavy drinking may disturb sleep, cause dehydration, and contribute to an irregular heart rhythm.
Stress causes the release of hormones that prepare the body to respond to danger. Your heart may beat faster, your breathing may change, and you may become more aware of physical sensations. This does not mean that every palpitation during stress is harmless, but it is a common explanation.
Palpitations that stop after the trigger is removed may be less concerning. Repeated episodes still deserve attention, especially when they are becoming more frequent, lasting longer, or interfering with daily life.
Medical Conditions That Can Cause Palpitations
Heart palpitations are not always caused by a problem inside the heart. Several medical conditions can change the heart rate or make the heartbeat feel more forceful.
Possible causes include:
Anaemia
An overactive thyroid
Low blood glucose
Fever or infection
Dehydration
Low blood pressure
Electrolyte imbalances
Hormonal changes
Sleep apnoea
Lung conditions
Anxiety disorders
Certain heart conditions
Anaemia reduces the blood’s ability to carry oxygen. The heart may beat faster to supply the body with enough oxygen, causing tiredness, breathlessness, dizziness, pale skin, and palpitations.
An overactive thyroid can increase the heart rate and may also cause sweating, weight loss, trembling, heat intolerance, anxiety, or difficulty sleeping.
Vomiting, diarrhoea, heavy sweating, and inadequate fluid intake can lead to dehydration or changes in electrolyte levels. Potassium, magnesium, sodium, and calcium help support normal electrical activity in the heart. Significant imbalances may affect the heartbeat.
Some medicines and supplements can trigger palpitations. These may include:
Certain asthma medicines
Decongestants
Some cold and flu remedies
Thyroid medication
Stimulant medication
Certain antidepressants
Weight-loss products
Herbal stimulants
Some blood pressure medicines
Do not stop prescribed medication without speaking to a healthcare professional. Dr Jolandi Meyer can review your medicines, supplements, and symptoms to determine whether a treatment may be contributing to the problem.
When Palpitations May Indicate an Abnormal Heart Rhythm
An arrhythmia is a problem with the rate or rhythm of the heartbeat. The heart may beat too quickly, too slowly, or irregularly. Some arrhythmias are harmless, while others require treatment.
Atrial fibrillation is one possible cause of heart palpitations. It creates an irregular heartbeat and may cause fatigue, dizziness, breathlessness, weakness, or reduced exercise tolerance. Some people have no noticeable symptoms.
Other rhythm disturbances include supraventricular tachycardia, premature beats, atrial flutter, ventricular arrhythmias, and unusually slow heart rhythms. It is not possible to identify the exact rhythm from the sensation alone.
Features that may suggest an arrhythmia include:
A very fast heartbeat that starts and stops suddenly
A persistently irregular pulse
Palpitations lasting several minutes or longer
Repeated episodes without a clear trigger
Palpitations during exercise
Reduced ability to exercise
Dizziness or weakness during an episode
A personal history of heart disease
A family history of serious rhythm disorders
A family history of sudden unexplained death
Palpitations during physical exertion need medical assessment, particularly when accompanied by chest discomfort, unusual breathlessness, dizziness, or fainting.
People with known heart disease, previous heart surgery, high blood pressure, diabetes, or a history of stroke should mention new palpitations to their doctor. An abnormal rhythm may require further investigation even when the symptoms seem mild.
Warning Signs That Require Urgent Medical Attention
Heart palpitations need urgent assessment when they occur with symptoms suggesting that the heart may not be pumping blood effectively or that another serious problem is developing.
Seek emergency medical help if you currently have palpitations accompanied by:
Chest pain, pressure, or tightness
Severe shortness of breath
Fainting
Feeling as though you may faint
Severe dizziness or light-headedness
Sudden confusion
Extreme weakness
Heavy sweating with chest discomfort
Pain spreading to the arm, shoulder, neck, jaw, back, or upper abdomen
A very fast or irregular heartbeat that does not settle
Do not drive yourself if you are experiencing severe symptoms. Ask someone to call emergency medical services or arrange urgent transport to an emergency department.
If serious symptoms occurred during an episode but have now stopped, you should still seek urgent medical advice. The disappearance of symptoms does not confirm that the cause was harmless.
Palpitations after recreational drug use, an overdose, or accidental exposure to a stimulant also require prompt medical attention. Be honest about any substance taken, as this information can guide safe treatment.
Pregnant women experiencing palpitations with chest pain, fainting, severe breathlessness, or significant weakness should receive urgent assessment. Pregnancy changes the circulation and heart rate, but severe symptoms should never be dismissed as a normal part of pregnancy.
When to Book an Appointment With a GP
Heart palpitations do not always require emergency care, but a routine or prompt appointment may still be important.
Book a consultation when:
Palpitations keep returning
Episodes are becoming more frequent
They last longer than before
There is no clear trigger
Your pulse feels persistently irregular
The symptoms disturb your sleep
You experience palpitations during exercise
You feel unusually tired or weak
You have unexplained weight loss
You have symptoms of anaemia
You recently started a new medicine or supplement
You have an existing heart condition
You have a family history of rhythm disorders
The symptoms are causing significant anxiety
New palpitations should be assessed when you have risk factors such as high blood pressure, diabetes, high cholesterol, smoking, obesity, or a previous heart problem.
You should also consult a doctor if you repeatedly assume the symptoms are caused by anxiety. Anxiety can certainly cause palpitations, but physical causes should be considered before every episode is attributed to stress.
Children and teenagers can experience palpitations too. Medical advice is appropriate when episodes recur, occur during sport, cause fainting, or are associated with a family history of sudden cardiac death.
A single brief episode after a clear trigger may settle without treatment. If you remain concerned, a medical consultation can provide reassurance and help identify avoidable triggers.
How Heart Palpitations Are Investigated
Your doctor will begin by asking detailed questions about the episodes. The pattern often provides important clues.
You may be asked:
When the palpitations started
How often they occur
How long they last
Whether they begin and end suddenly
What you were doing at the time
Whether the rhythm felt fast, irregular, or forceful
Which other symptoms occurred
What medicines and supplements you use
How much caffeine or alcohol you consume
Whether you smoke or use recreational drugs
Whether heart problems run in your family
A physical examination may include checking your pulse, blood pressure, oxygen level, temperature, heart sounds, and signs of thyroid disease or anaemia.
An electrocardiogram, commonly called an ECG, records the heart’s electrical activity. It can identify certain rhythm disturbances, previous heart damage, or other abnormalities. A standard ECG only captures a short period, so it may appear normal when the palpitations are not happening.
If episodes come and go, longer monitoring may be recommended. A Holter monitor records the heart rhythm continuously for a day or longer. An event monitor may be used for less frequent symptoms.
Other possible investigations include:
Full blood count
Thyroid function tests
Blood glucose testing
Electrolyte tests
Kidney function tests
An echocardiogram
Exercise testing
Referral to a cardiologist
The tests selected will depend on your symptoms, examination, medical history, age, and risk factors.
Keeping a Record of Your Symptoms
A symptom diary can help your doctor understand the pattern of your heart palpitations. Memory can become unreliable when episodes are brief or frightening, so recording details soon afterwards is useful.
Write down:
The date and time
How long the episode lasted
What the heartbeat felt like
What you were doing before it started
Food and drinks consumed
Caffeine or alcohol intake
Medicines and supplements taken
Stress or anxiety levels
Hours of sleep
Associated symptoms
What helped the episode stop
If possible, check your pulse during an episode. Note whether it feels regular or irregular and count the beats for a full minute. Do not delay urgent care to measure your pulse when warning signs are present.
Smartwatches and fitness devices may record heart rate or rhythm information. These devices can provide useful clues, but they cannot confirm or exclude every heart condition. A normal reading does not replace a medical assessment when symptoms are concerning.
Avoid checking your pulse repeatedly throughout the day when there are no symptoms. Constant monitoring can increase anxiety and make normal variations in heart rate feel alarming.
Bring your diary and any device recordings to your appointment. This information may help Dr Meyer decide which investigations are most appropriate.
Treatment and Practical Ways to Reduce Palpitations
Treatment depends on the cause. Harmless palpitations may improve through lifestyle changes, while an underlying medical condition or arrhythmia may need specific treatment.
Practical measures may include:
Reducing caffeine
Avoiding energy drinks
Limiting alcohol
Stopping smoking
Avoiding recreational stimulants
Drinking enough water
Eating regular, balanced meals
Improving sleep habits
Managing stress
Reviewing medicines and supplements
Increasing exercise gradually when medically safe
Do not attempt to treat repeated palpitations by taking someone else’s heart medication. Medicines that slow the heart can be dangerous when used without medical supervision.
If anaemia, thyroid disease, dehydration, infection, or an electrolyte imbalance is responsible, treating that condition may resolve the palpitations.
An arrhythmia may require medication, a procedure, or specialist monitoring. Treatment depends on the type of rhythm disturbance, its severity, the symptoms it causes, and the person’s general health.
Anxiety-related palpitations can feel physically intense. Slow breathing, relaxation exercises, counselling, and treatment for an anxiety disorder may help. The symptoms should still be assessed when they are new, persistent, or accompanied by warning signs.
Reducing known triggers can be useful, but you do not need to remove every possible trigger at once. A symptom diary can help identify which changes make a genuine difference.
How Dr Jolandi Meyer Can Help
Dr Jolandi Meyer is a GP in Pretoria who can assess heart palpitations and determine whether they are likely to be caused by lifestyle factors, medication, anxiety, an underlying medical condition, or a heart rhythm problem.
During your consultation, Dr Meyer can review the pattern of your symptoms, examine you, check your pulse and blood pressure, and assess your cardiovascular risk factors. She can also review prescription medicines, over-the-counter products, vitamins, herbal remedies, caffeine intake, and alcohol use.
Blood tests may be recommended to investigate anaemia, thyroid problems, blood glucose changes, electrolyte imbalances, kidney function, or other possible causes. An ECG may be arranged to examine the heart’s electrical activity.
If the palpitations are intermittent, Dr Meyer may recommend longer heart rhythm monitoring. She can also arrange a referral to a cardiologist when specialist assessment, an echocardiogram, exercise testing, or further investigation is needed.
A consultation can provide reassurance when the symptoms are harmless and create a clear treatment plan when a medical cause is identified. Contact Dr Jolandi Meyer’s Pretoria practice if your palpitations keep returning, are changing in pattern, or are affecting your daily life.
Heart palpitations are common and are often linked to stress, caffeine, dehydration, poor sleep, or other manageable triggers. They can also signal an abnormal rhythm or an underlying medical condition, particularly when episodes recur or occur during exercise. Seek emergency help when palpitations accompany chest pain, severe breathlessness, fainting, or marked dizziness.
For less urgent but persistent symptoms, book an appointment with Dr Jolandi Meyer in Pretoria. A careful assessment can identify the cause, guide treatment, and give you greater confidence about your heart health.
Common Ailments Treated by Dr. Jolandi Meyer
Dr. Jolandi Meyer’s expertise and comprehensive treatment options make her an exceptional General Practitioner for addressing all ailments. She provides personalised care, empowering patients to achieve optimal health. Her compassionate approach ensures patients receive the highest quality treatment. Her practice is located in Garsfontein, Pretoria on the same premises as The Way Recovery Centre.
With her support and guidance, patients can embark on a journey towards improved well-being and a healthier, happier life.