Heart palpitations: when to worry, and when not to

Almost everyone feels their heart flutter, pound or skip now and then. Most palpitations are extra beats that start in the upper or lower chambers of the heart, and they are harmless. Caffeine, alcohol, stress, poor sleep and dehydration all make them more likely.

Usually nothing to worry about

• A single skipped or thumping beat, followed by a normal rhythm.

• A racing heart during exercise, anxiety or after a strong coffee that settles within minutes.

• Palpitations that come and go without any other symptoms.

Worth a visit

Book a cardiology appointment if palpitations last more than a few minutes, come with dizziness or breathlessness, wake you at night, or if you have a family history of heart rhythm problems or sudden death at a young age.

Call 911 if palpitations come with chest pain, fainting or severe shortness of breath.

What we do

Most visits start with an ECG and a conversation. If the palpitations are occasional, a small monitor worn for one to fourteen days usually catches them, and an echocardiogram shows whether the heart's structure is normal. In most cases the result is reassurance, and a few simple changes to caffeine, sleep and hydration.

This article is general information, not medical advice.