Palpitations and Irregular Heartbeats: When to Seek Assessment

Summary

This guide explains what heart palpitations and irregular heartbeats really mean, when they are harmless, when they need medical assessment, and what to do next. It is written for adults who experience noticeable heartbeats, fluttering, skipping sensations or racing pulses and feel unsure whether to worry. It also outlines when self-care is appropriate, when to see a GP or pharmacist, and when consultant-level review is helpful.

Who this guide is for

This guide is for you if:

1.    You have episodes where your heart feels like it is racing, fluttering, pounding or skipping beats.

2.    You are unsure whether the symptoms are caused by stress, caffeine, anxiety, exercise or something more significant.

3.    You feel well enough to stay at home but are worried because the sensations keep coming back.

4. You want to understand when to worry about heart palpitations and when you should seek proper assessment.

If you are currently experiencing severe chest pain, collapse, intense breathlessness or any other emergency symptoms, this guide is not suitable —you must seek urgent help instead.

Red flag checklist: when to seek urgent help

Call 999 or attend A&E immediately if you have:

1.    Chest pain that is severe, crushing or spreading to the arm, jaw or back.

2.    Sudden shortness of breath, difficulty speaking, or blue lips or face.

3.    Collapse, fainting, or episodes where you are hard to wake.

4.    New weakness in the face, arm or leg, or sudden difficulty speaking.

5.    A racing heart that will not slow down and is accompanied by dizziness, chest discomfort or breathlessness.

6.    A heart rate consistently above 140 beats per minute at rest.

7.    Any palpitations linked to severe dizziness, near-blackouts or confusion.

This clinic is not an emergency service. If your symptoms are severe, getting worse quickly, or you think they might be life-threatening, call 999 or attend your nearest A&E immediately.

Common reasons for palpitations and irregular heartbeats

Once red flags are ruled out, most people fall into one of the following groups. This is not a full diagnostic list but a helpful way to understand common patterns.

1. Benign or self-limiting causes

These include:

·         Stress, anxiety or panic attacks

·         Caffeine, energy drinks or alcohol

·         Dehydration or lack of sleep

·         Hormonal changes, including peri-menopause

·         Fever or mild illness

These palpitations are often brief, settle with simple measures, and are not dangerous.

2. Heart rhythm issues that need proper assessment

These include:

·         Ectopic beats (missed beats or extra beats)

·         Atrial fibrillation (irregular rhythm that increases stroke risk)

·         Supraventricular tachycardia (SVT)

·         Fast or slow heart rhythms due to electrical conduction issues

These can cause racing, thudding or irregular beats and may come and go.

3. Underlying medical conditions

Palpitations can also be a sign of:

·         Thyroid problems

·         Low iron levels (anaemia)

·         High or low blood pressure

·         Dehydration or infection

·         Low blood sugar

·         Side effects of medications

These conditions often need blood tests or monitoring to diagnose.

4. A mix of physical and emotional factors

Many people experience a blend of physical triggers and emotional strain. Even if stress plays a role, it is still important to check for underlying medical issues — palpitations should never be dismissed automatically as “just anxiety”.

What you can safely do at home for now

If you have no red flags and feel stable day to day, these steps can help:

1. Track your episodes

·         Note when palpitations happen, how long they last and what you were doing.

·         Record any triggers, such as caffeine, alcohol, lack of sleep or exercise.

2. Stay hydrated and reduce stimulants

Cut down on caffeine, energy drinks and alcohol for a week to see if symptoms improve.

3. Check basic measurements if you can

·         Use a home blood pressure machine correctly and write down your readings.

·         Some watches can record heart rhythm irregularities — save these for medical review.

4. Manage stress where possible

Gentle breathing, fresh air, rest and small breaks can make a difference.

5. Pharmacy support

A pharmacist can advise on whether symptoms might be linked to medication or over-the-counter stimulants.

If your palpitations are becoming more frequent, lasting longer, or affecting daily life, move to the next step.

When and how to seek non-emergency medical help

1. Start with your GP

Your GP can:

·         Review your history

·         Check thyroid function and iron levels

·         Discuss medication side effects

·         Arrange basic ECGs

Many palpitations can be managed fully in general practice.

2. Consider a consultant physician when:

·         Your symptoms are becoming more frequent or disruptive.

·         You have palpitations with dizziness, breathlessness or chest discomfort (but not severe enough for A&E).

·         You have had tests, but still do not understand what they mean.

·         You want a senior medical opinion on whether your symptoms might reflect heart rhythm issues.

·         You are unsure whether you need further tests, such as Holter monitoring.

3. Choosing between online and in-person care

·         Online works well for history taking, reviewing watch recordings or planning investigations.

·         In person is better if you need a physical examination, a blood pressure check or a detailed cardiovascular assessment.

If you keep wondering “heart palpitations when to worry”, you are precisely the kind of person who may benefit from structured consultant-level assessment.

How Dr Paraiso’s clinic can help

Dr Hassan Paraiso is a consultant in Acute and General Internal Medicine who sees adults with palpitations, irregular heartbeats and symptoms that fall between “not emergency” and “not simple”.

You can access his care in three ways:

1. In-person clinic in Salford

• Location: Eric Healthcare, Bowsall House, 3 King Street, Salford, M3 7DG

• Telephone: 0121 838 1869

·        Includes a detailed assessment of symptoms, blood pressure checks, cardiovascular examination and review of existing tests.

2. Online consultations across the UK

·         Suitable for many rhythm concerns, second opinions and explanation of previous tests.

·         If an in-person examination becomes necessary, this will be arranged.

3. Direct access tests (UK-wide)

·         Holter heart rhythm monitoring (24 hours or longer) for palpitation episodes.

·         Private blood tests to check thyroid function, iron levels and other causes.

·         Clear written reports and the option of follow-up consultation.

After any assessment, you receive a summary letter in plain English that can be shared with your GP. The aim is to work with NHS care, not replace it.

If this sounds like your situation and it is not an emergency, you can find out more and arrange an in-person or online consultation at DrParaiso.co.uk.

Frequently asked questions

1. Are palpitations always dangerous?

No. Many are benign, but some patterns need medical review. The aim is to identify which is which.

2. Can palpitations be assessed online?

Often yes. A detailed history plus smartwatch data, previous tests, or a symptom diary can guide the next steps.

3. Do I always need a Holter monitor?

Not always. It is useful when symptoms come and go or when irregular rhythms are suspected.

4. Will you write to my GP?

Yes. A clear summary letter is provided to keep your GP informed.

5. What if you think my symptoms are an emergency?

You will be advised to attend A&E immediately. Safety always comes first.

Key takeaways

·         Palpitations are common and often harmless but should not be ignored.

·         Seek urgent help for chest pain, collapse, severe breathlessness or high-speed heart rates.

·         Track episodes, reduce stimulants and check basic signs at home.

·         See your GP or a consultant if symptoms persist, increase or cause concern.

·         Dr Paraiso offers in-person assessments in Edgbaston, online reviews UK-wide, and Holter monitoring to clarify the cause.

Final safety reminder

This clinic is not an emergency service. If your symptoms are severe, getting worse quickly, or you think they might be life-threatening, call 999 or attend your nearest A&E immediately.