Health Insights · Cardiology
Palpitations: when a racing heart needs checking
Becoming aware of your own heartbeat is common and usually harmless — extra beats, a thump, a flutter. What determines whether it matters is the company it keeps: what you were doing, how long it lasted, and whether anything else happened at the same time.
Call 999 if palpitations come with
- chest pain, tightness or pressure
- fainting, or nearly fainting
- severe breathlessness, or breathlessness at rest
- a heart rate that is very fast and does not settle after several minutes of rest
- palpitations during exercise rather than after it
Arrange prompt assessment, rather than an ambulance, if you have a family history of sudden unexplained death under 40, known heart disease, or palpitations that are becoming more frequent. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
The common, harmless kind
Extra beats — ectopics — are felt as a missed beat followed by a thump. They are extremely common, occur in healthy hearts, and are typically noticed most when you are still, in bed or stressed. Paradoxically they often reduce during exercise, which is reassuring.
- caffeine, energy drinks and excessive tea or coffee
- alcohol, particularly binge drinking — sometimes called holiday heart
- nicotine, cannabis, cocaine and stimulants
- stress, anxiety and poor sleep
- dehydration, missed meals and low potassium or magnesium
- decongestants, salbutamol inhalers, thyroid medicine and some antidepressants
- fever, anaemia, an overactive thyroid, and the menopause
Atrial fibrillation
AF is an irregular, often fast heart rhythm. It may cause palpitations, breathlessness or fatigue — or no symptoms at all. It matters because it substantially increases the risk of stroke, and because that risk is largely preventable with anticoagulation.
- Check your own pulse: feel at the wrist for 30 seconds. AF is irregularly irregular — no pattern at all to the gaps.
- Many smartwatches and phone devices detect AF reasonably well. A notification is worth acting on, though it needs confirming with a proper ECG.
- AF becomes more common with age, high blood pressure, alcohol, sleep apnoea, thyroid disease and being overweight.
- If AF is confirmed, the two questions are rate or rhythm control, and whether you need anticoagulation to prevent stroke. The second is the one that changes lives.
Capturing an episode is the whole difficulty
Palpitations are intermittent, and an ECG taken while you feel fine is often normal. That does not mean nothing is wrong — it means we have not caught it yet. Options are a 24-hour or 7-day monitor, a patch worn for up to two weeks, or an event recorder you activate during an episode. Keeping a simple diary — time, what you were doing, how long, how it stopped, and your pulse if you can take it — is genuinely valuable and costs nothing.
Slowing a fast regular palpitation
Some fast regular rhythms respond to manoeuvres that stimulate the vagus nerve. If you have been shown these and told they are appropriate for you: bear down as if straining, or blow hard against a closed mouth and pinched nose for 15 seconds. Do not press on your neck or eyes. If the episode does not stop within a few minutes, or you feel unwell, call for help.
Reducing episodes
- Cut caffeine substantially for two weeks and see whether it changes anything — a genuine test rather than a vague reduction.
- Reduce alcohol; it is a far more common trigger than people expect.
- Address sleep, including snoring and daytime sleepiness, which may indicate sleep apnoea.
- Regular aerobic exercise reduces ectopics in most people.
- Have thyroid function and a full blood count checked — anaemia and thyroid problems are easily missed causes.
Book an appointment if palpitations are frequent, prolonged, or accompanied by any of the warning symptoms, if you have an irregular pulse, or if a wearable device has flagged a possible rhythm problem. We offer ECG, echocardiography and cardiology review on site, with ambulatory monitoring arranged through our CQC-registered partners.
Private cardiology assessment for palpitations in London
Palpitations — a racing, thumping or skipping heartbeat — are often harmless, but they sometimes point to a rhythm problem worth diagnosing. A private GP in East London can arrange an ECG (sometimes over a longer period) and blood tests, and our private cardiology clinic in London can assess you further where needed. Palpitations with chest pain, fainting or severe breathlessness need urgent care. Palpitations are assessed at our private cardiology service in Whitechapel, East London, close to Canary Wharf, Aldgate and the City.
Palpitations: when a racing heart should be checked
Are palpitations dangerous?
Usually not, but palpitations with fainting, chest pain or breathlessness, or that are frequent and prolonged, should be assessed.
How are palpitations investigated?
With an ECG — sometimes a 24-hour or longer recording to capture the rhythm — plus blood tests to check for triggers.
Can I be seen the same day?
Yes — same-day private GP and ECG appointments are available most days at our Whitechapel clinic.
What can trigger palpitations?
Caffeine, stress, alcohol, thyroid problems and anaemia are common triggers, which we can check for.
Where can I get palpitations checked near me in East London?
Our ECG and heart check in London and private cardiology clinic in London at Whitechapel, near Canary Wharf, can assess palpitations.
When are palpitations an emergency?
Palpitations with chest pain, breathlessness or blackouts need urgent care — call 999; otherwise a cardiac diagnostics assessment can find the cause.
ECG and echocardiography on site
Same-day appointments most days, 7 days a week, 9am–7pm, on Whitechapel Road.