Palpitations emergency department leaflet

• You have been seen in the Emergency Department because of heart palpitations. This leaflet discusses possible causes, how to avoid a recurrence and when to seek help.

• Heart palpitations are heartbeats that suddenly become more noticeable. Palpitations may seem alarming and be uncomfortable.

• Although palpitations can be caused by abnormal rhythms such as supraventricular tachycardias (SVTs) and atrial fibrillation which may require treatment, this is unusual and the vast majority do not need any treatment.

• During your visit, we may have carried out a trace of your heart (an ECG, electrocardiogram) and taken some observations of your heart rate, blood pressure and temperature. We may also have taken blood tests or a chest x ray.

• If you are getting recurrent episodes of palpitations it is worth discussing this with your GP who may arrange further outpatient tests such as a 24 hour ECG monitor.

• This leaflet also explains when you should seek urgent medical attention.

• Heart palpitations are heartbeats that suddenly become more noticeable.

• You may feel your heart is pounding, fluttering or beating irregularly, often for just a few seconds or minutes. You may also feel these sensations in your throat or neck.

• Palpitations are often most noticeable at night or when you are alone.

• Palpitations may seem alarming, but in most cases they're harmless and aren't a sign of a serious problem.

• Sometimes you may feel an extra or missed beat. These are known as ectopic beats and are also usually nothing to worry about.

Causes of heart palpitations include:

• Lifestyle triggers.
• Emotions and psychological triggers.
• Medication.
• Hormone changes.
• Heart rhythm problems.
• Heart conditions.
• Other medical conditions.

Life style triggers include: strenuous exercise; not getting enough sleep; drinks containing caffeine, alcohol; smoking; recreational drugs, rich or spicy foods. In these cases, the palpitations should go away without any treatment. Avoiding these triggers may help stop them coming back.

Excitement, anxiety, stress and panic attacks can also cause palpitations. Breathing exercises and panic attack tips may help if you're feeling stressed, anxious or panicky.

A variety of medications can sometimes cause palpitations. These include asthma medications, some blood pressure medications, antihistamines, macrolide antibiotics, some antidepressants and antifungal medications. Speak to your GP if you think your medication may be the cause.

Hormonal changes during a woman’s period, pregnancy or the menopause may cause palpitations – these are usually temporary.

Specific heart rhythms such as atrial fibrillation, atrial flutter, supraventricular tachycardia and ventricular tachycardias are known as arrhythmias.

Certain heart conditions associated with heart valves, enlarged heart muscles and reduced pumping ability of the heart may also cause palpitations.

Other medical conditions such as thyroid problems, anaemia, low blood sugar, fever, dehydration and a low blood pressure on standing can also cause palpitations.

You don't usually need to see your GP if the palpitations pass quickly and occur only occasionally. They're unlikely to be caused by a serious problem and probably won't need treatment.

You should see your GP if:

• The palpitations last a long time, don't improve or get worse.
• You have a history of heart problems.
• You are concerned about the palpitations.

Your GP may arrange further tests or refer you to an outpatient clinic at your local hospital.

Call 999 or attend your local A&E if you have heart palpitations along with any of the following symptoms

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

These symptoms could indicate a serious or potentially life threatening heart problem that should be checked by a doctor as soon as possible.

• For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.
• The NHS website provides online health information and guidance.
• There are walk-in and urgent treatment services at Brighton Station, Crawley Urgent Treatment Centre, Lewes Victoria Hospital, Horsham Minor Injuries Unit and Bognor Regis War Memorial Hospital.

The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.