Palpitations and a noticeable heartbeat

Overview

Palpitations describe being unusually aware of your heartbeat. It may feel fast, irregular, pounding or fluttering. The sensation has different possible causes, and the description alone cannot establish the rhythm or whether treatment is needed.

The context matters: whether an episode happens at rest or during activity, how it begins and ends, and what accompanies it. A short account of the episode is often more useful than trying to decide which heart condition it resembles.

By telephone

If there are no current emergency symptoms, a call can help organise the history and identify the appropriate next assessment. Discuss recent illness, sleep, caffeine, alcohol, medicines and any previous cardiac investigations. These questions help build context without assuming that a lifestyle factor is the explanation.

Explain whether the main concern is an ongoing episode, recurrent brief events or a device alert. If you have a saved recording, tell the doctor what device produced it. An automated message and a clinician-interpreted heart tracing are different kinds of information.

What cannot be done remotely

A telephone consultation cannot record the heart’s electrical activity or examine you. An ECG records rate and rhythm; sometimes a portable recording or further assessment is needed because symptoms come and go.

Feeling normal between episodes does not settle the cause. The doctor may advise prompt in-person assessment rather than a routine review. Ask what to do if another episode occurs and which associated symptoms should change the urgency.

What to prepare

• Note when episodes occur, how long they last and whether they stop abruptly.
• Describe chest discomfort, faintness or breathlessness, even if these have stopped.
• Have current medicines and previous ECG or specialist reports available.
• Mention a personal or family history of heart problems.

Sources

• NHS: heart palpitations
• NHS: ECG testing