Stress and anxiety can manifest themselves in many different ways, affecting both our mental and physical health. This week, at London Doctors Clinic, we are focusing on stress, as part of stress awareness month, and in this article we will be discussing heart palpitations.


What Are Heart Palpitations?

This is the term given to the sensation of your heartbeat becoming more noticeable. Most of us don’t notice our heart beating in our day to day life unless we are nervous or excited, but if you experience this sensation at other times, this is often referred to as having 'palpitations'.


How Do I Know If I'm Having Palpitations?

You may feel like your heart is beating harder than normal, fluttering or even beating irregularly, and this unusual sensation may last for just a few seconds or up to a few minutes. Some people have these feelings in the neck or throat too.

Some people might feel like their heart has an extra beat or even missed a beat. These are known as 'ectopic beats'.


Heart Palpitations Causes

Heart palpitations can be due to lifestyle triggers, emotional factors, medications, hormone changes, heart rhythm problems, heart problems or other medical problems.


Lifestyle Triggers

Heart palpitations might be started off by the following activities:

  • Strenuous exercise
  • Not sleeping enough
  • Drinking caffeine (in drinks such as tea, coffee or energy drinks)
  • Alcohol
  • Smoking
  • Recreational drugs (such as cocaine, heroin, ecstasy)
  • Rich or spicy foods

If you find yourself experiencing palpitations after any of the above events, and you believe this activity triggered the palpitation, then you should should try and avoid this activity again in future, to prevent further palpitations.



Unfortunately, drinking caffeinated drinks (including coffee) may trigger heart palpitations


Emotional Factors

Excitement, nervousness, stress or anxiety can all cause palpitations, but these feelings should pass when you feel calmer.

Some people may get palpitations together with panic attacks. Panic attacks involve an overwhelming sense of anxiety or fear together with feeling sick, sweating, trembling and palpitations. If you are experiencing these symptoms, there are breathing exercises and other tips that might help you.



Palpitations can be triggered by specific drugs including:

  • Asthma inhalers - Especially salbutamol and ipratropium
  • Some high blood pressure medications - Such as hydralazine or minoxidil
  • Antihistamines - Including terfenadine
  • Antibiotics - Especially clarithromycin and erythromycin
  • Antidepressants - Including citalopram
  • Antifungal medications - For example, itraconazole

If you think a certain medication may be causing your palpitations, your doctor may suggest slowly lowering the dose, stopping the medication, or changing it for another similar medication that should not have this effect.

Do not make changes to your medication regimen without first consulting a doctor.


Hormone Changes

In women in particular, heart palpitations can coincide with a woman’s periods, with pregnancy or with the menopause. These may be harmless, but it's always important to speak to a doctor about this just in case, especially if you experience palpitations while pregnant.


Heart Rhythm Problems

Sometimes palpitations are caused by a problem with the heart rhythm itself. The medical term for this is an arrhythmia. Some of the more common arrhythmia are summarised below:

1. Atrial Fibrillation (AF)

Atrial fibrillation (AFib) is a relatively common condition that can cause a fast irregular heart beat.

2. Atrial Flutter

This is a condition whereby there is a defect in the heart's rhythm, causing the heart to beat at a faster rate, with either a regular or irregular rhythm

3. Supraventricular Tachycardia (SVT)

This is particularly common in young people who are often otherwise healthy. They may experience episodes of fast but regular heart rate.

4. Ventricular Tachycardia

A more serious problem involving a fast regular, heart rate which may also involve dizziness or blackouts.


Heart Conditions

Problems with the heart valves, heart failure or other rarer conditions such as cardiomyopathies (abnormalities of the heart muscle) can also cause palpitations. These conditions are often serious and usually require treatment.


Other Medical Problems

Other conditions in which heart palpitations can sometimes occur include the following:

  • Overactive thyroid gland (hyperthyroidism)
    • When there is too much thyroid hormone being produced by the thyroid gland
  • Low blood sugar (hypoglycaemia)
    • Especially if you have diabetes
  • Anaemia
    • Whereby you have low levels of red blood cells
  • Postural or orthostatic hypotension 
    • This is a condition whereby you experience dizziness and low blood pressure when you change position, especially when you stand up
  • High temperature of 38 degrees or more
  • Dehydration


Heart Palpitations: When To See The GP

First of all, if you're at all concerned about these palpitations, it's always better to be on the safe side and speak to a doctor about them. If they're caused by anxiety, not seeing a doctor will lead to more anxiety, further exacerbating the problem!

You should especially visit your GP if:

  • The palpitations last for a long time
  • They don't improve, or get worse
  • You've ever had heart problems in the past


When To Seek Emergency Help

It is crucial to call 999 for an ambulance or visit your nearest accident and emergency (A&E) department if you have heart palpitations together with any of these symptoms:

  • Severe shortness of breath
  • Chest pain or tightness
  • Dizziness or light-headedness
  • Fainting or blackouts



If you have any of these above mentioned symptoms in addition to palpitations, this could suggest you have a very serious and possibly life-threatening heart problem that needs to be checked by a doctor as soon as possible.


If you would like to speak to a doctor about any of the topics mentioned in this article, from palpitations and heart conditions, to stress and anxiety, you can find us at any of our 9 central London clinics! Book in today, for peace of mind.