What Are Heart Palpitations?

Heart palpitations describe an unusual awareness of the heartbeat. They may feel like:

• A racing heartbeat
• Pounding in the chest
• Fluttering
• Skipped beats
• Extra beats
• A sudden pause followed by a strong beat
• An irregular heartbeat
• Pulsing in the neck or throat

Palpitations may last only a few seconds or continue for several minutes. Some patients experience them occasionally, while others notice symptoms several times a day.

When Should You Visit a Heart Palpitations Clinic?

A cardiology consultation may be recommended when palpitations:

• Occur repeatedly
• Begin suddenly without an obvious trigger
• Last longer than usual
• Occur during exercise
• Wake you from sleep
• Appear with chest pain
• Cause shortness of breath
• Occur with dizziness or weakness
• Are associated with fainting
• Affect daily activities
• Are detected by a smartwatch or home ECG device

Palpitations should also be evaluated when there is a history of heart disease, high blood pressure, thyroid disease, or arrhythmia.

What Causes Heart Palpitations?

Heart palpitations can have cardiac and non-cardiac causes.

Possible Heart-Related Causes

• Premature atrial contractions
• Premature ventricular contractions
• Atrial fibrillation
• Supraventricular tachycardia
• Bradycardia
• Tachycardia
• Heart valve disease
• Structural heart disease
• Cardiomyopathy
• Other cardiac arrhythmias

Lifestyle and Temporary Causes

• Stress
• Anxiety
• Lack of sleep
• Dehydration
• Excessive caffeine
• Alcohol
• Smoking
• Intense exercise
• Fever
• Fatigue

Medical and Hormonal Causes

• Thyroid disorders
• Anemia
• Electrolyte imbalance
• Low blood sugar
• Menopause
• Pregnancy
• Certain medications
• Cold medicines or decongestants
• Weight-loss supplements
• Energy drinks

Because different conditions can produce similar sensations, testing may be needed to identify the cause.

Palpitations and an Irregular Heartbeat

An irregular heartbeat may feel like the heart is skipping, fluttering, or beating unpredictably. Some irregular rhythms are harmless, while others require treatment or continued monitoring.

An ECG may identify an arrhythmia if it is occurring during the clinic visit. When symptoms are intermittent, longer heart rhythm monitoring may be more useful.

Palpitations at Rest

Some patients notice palpitations while sitting, lying down, or preparing to sleep. This may happen because the heartbeat becomes easier to notice in a quiet environment.

However, palpitations at rest may also be related to:

• Premature heartbeats
• Atrial fibrillation
• Stress or anxiety
• Thyroid conditions
• Caffeine or alcohol
• Medication side effects
• Changes in the autonomic nervous system

Recurring symptoms should be assessed rather than automatically assumed to be caused by anxiety.

Palpitations During Exercise

A fast heartbeat during exercise can be normal. However, evaluation may be recommended when the heartbeat:

• Becomes suddenly very fast
• Feels irregular
• Continues after exercise has stopped
• Occurs with chest discomfort
• Causes dizziness
• Reduces exercise tolerance
• Leads to fainting or near-fainting

An exercise stress test may be considered when symptoms appear mainly during physical activity.

Palpitations After Eating

Some people experience palpitations after meals, particularly after consuming large meals, caffeine, alcohol, spicy foods, or high-sugar foods.

Symptoms may also be influenced by acid reflux, blood sugar changes, dehydration, or stimulation of the nervous system. Repeated episodes should be discussed with a cardiologist, especially when they occur with chest pain or breathlessness.

Palpitations at Night

Nighttime palpitations may occur when lying in bed or waking from sleep. Common triggers include stress, poor sleep, alcohol, caffeine, or changes in heart rhythm.

Monitoring may be helpful when the palpitations:

• Wake you frequently
• Last several minutes
• Feel very fast or irregular
• Occur with sweating
• Cause breathing difficulty
• Are becoming more frequent

Heart Palpitations and Anxiety

Anxiety can cause a rapid heartbeat, chest tightness, shaking, sweating, and shortness of breath. Palpitations may then increase anxiety, creating a cycle of worsening symptoms.

However, a heart rhythm problem can produce similar symptoms. A cardiovascular evaluation can help determine whether the heartbeat is normal, stress-related, or caused by an arrhythmia.

Heart Palpitations in Women

Hormonal changes may affect heart rhythm awareness. Women may experience palpitations during:

• Menstruation
• Pregnancy
• Perimenopause
• Menopause
• Periods of emotional stress
• Sleep deprivation

Other possible causes include anemia, thyroid disease, medication use, and arrhythmia. Persistent or worsening symptoms should be evaluated.

Heart Palpitations in Younger Adults

Palpitations in younger adults are frequently associated with stress, energy drinks, caffeine, dehydration, or lack of sleep. However, younger patients may also develop supraventricular tachycardia, premature heartbeats, or inherited rhythm conditions.

Evaluation is especially important when palpitations occur with exercise, fainting, chest pain, or a family history of sudden cardiac death.

How Heart Palpitations Are Evaluated

Dr. Lim Do-Sun may ask:

• When the palpitations started
• How often they occur
• How long each episode lasts
• Whether the heartbeat feels fast or irregular
• What triggers the symptoms
• Whether symptoms begin and end suddenly
• Whether chest pain or dizziness occurs
• Whether the patient has fainted
• Which medications or supplements are being used
• Whether caffeine, alcohol, or energy drinks are consumed
• Whether there is a family history of arrhythmia

Testing is selected based on the frequency, pattern, and severity of the symptoms.

Tests for Heart Palpitations

Electrocardiogram

An ECG records the electrical activity of the heart. It may detect an abnormal rhythm, conduction problem, or other finding that requires further evaluation.

Holter Monitoring

A Holter monitor records the heartbeat continuously during normal daily activities. It can be helpful when palpitations occur frequently but are not present during the clinic visit.

Longer Heart Rhythm Monitoring

When symptoms occur less often, longer monitoring may be recommended to increase the chance of recording the heartbeat during an episode.

Echocardiogram

An echocardiogram evaluates heart structure, pumping function, valves, and blood flow. It may be recommended when structural heart disease is suspected.

Exercise Stress Test

A stress test may be appropriate when palpitations occur during exercise or when physical activity causes chest discomfort or breathing difficulty.

Blood Tests

Blood testing may assess:

• Thyroid function
• Anemia
• Electrolyte levels
• Blood sugar
• Inflammation
• Other possible medical causes

Smartwatch and Mobile ECG Recordings

Smartwatches and portable ECG devices may capture useful information during an episode. Patients are encouraged to bring:

• Smartwatch ECG recordings
• Heart rate graphs
• Episode notifications
• Screenshots showing irregular rhythms
• Dates and times of symptoms

These recordings do not replace medical testing, but they may help the cardiologist understand when and how symptoms occur.

Who Should Consider Heart Rhythm Testing?

Heart rhythm evaluation may be appropriate for patients with:

• Repeated palpitations
• A fast resting heartbeat
• Skipped or extra beats
• An irregular pulse
• Palpitations during exercise
• Unexplained dizziness
• Fainting or near-fainting
• Chest pain
• Shortness of breath
• Reduced exercise capacity
• Previous abnormal ECG findings
• A family history of arrhythmia

Heart Palpitations Evaluation for International Patients

Dr. Lim Do-Sun Cardiovascular Clinic provides heart rhythm evaluation for expatriates, travelers, international residents, students, and overseas patients in Seoul.

International patients may bring:

• Previous ECG results
• Holter monitor reports
• Echocardiogram reports
• Blood test results
• Medication lists
• Smartwatch recordings
• Overseas cardiology reports
• Previous emergency room records

Existing medical information can help guide the consultation and reduce unnecessary repeated testing.

Why Choose Dr. Lim Do-Sun Cardiovascular Clinic?

The clinic provides:

• Cardiologist-led heart rhythm evaluation
• ECG testing
• Holter monitoring
• Echocardiography
• Exercise-related symptom assessment
• Cardiovascular risk evaluation
• Review of smartwatch ECG recordings
• Review of overseas medical records
• Personalized testing and follow-up
• Support for international patients in Seoul

The goal is to identify whether palpitations are harmless, lifestyle-related, or connected to an arrhythmia that requires monitoring or treatment.

When Are Heart Palpitations an Emergency?

Seek emergency medical care immediately when palpitations occur with:

• Severe chest pain
• Fainting
• Severe shortness of breath
• Sudden weakness
• Confusion
• Loss of consciousness
• A very fast heartbeat that does not settle
• New neurological symptoms
• Severe dizziness or collapse

A routine clinic appointment should not delay emergency treatment.

Book a Heart Palpitations Consultation in Seoul

Recurring palpitations can be difficult to diagnose because they may disappear before a clinic visit. Recording the heart rhythm during an episode and selecting the appropriate monitoring method can help identify the cause.

Dr. Lim Do-Sun Cardiovascular Clinic offers personalized heart palpitation and arrhythmia evaluation for Korean and international patients seeking cardiology care in Seoul.

Frequently Asked Questions

Are heart palpitations dangerous?

Many palpitations are not dangerous, but some may be caused by an arrhythmia. Evaluation is recommended when symptoms recur or appear with chest pain, dizziness, fainting, or breathlessness.

What do heart palpitations feel like?

They may feel like racing, pounding, fluttering, skipped beats, extra beats, or an irregular heartbeat.

Can stress cause heart palpitations?

Yes. Stress and anxiety can increase heart rate and make the heartbeat more noticeable. However, repeated symptoms should still be evaluated when the cause is uncertain.

Can caffeine cause palpitations?

Yes. Coffee, tea, energy drinks, and other sources of caffeine may trigger palpitations in sensitive individuals.

Why is my ECG normal even though I have palpitations?

A standard ECG only records the heart for a short period. If the palpitations are not occurring during the test, Holter or longer-term monitoring may be recommended.

What is the best test for intermittent palpitations?

The most appropriate test depends on how often symptoms occur. Holter monitoring may be useful for frequent symptoms, while longer monitoring may be considered for less frequent episodes.

Should I bring my smartwatch ECG?

Yes. Smartwatch ECG recordings and heart rate graphs may provide helpful information during the consultation.

Can thyroid problems cause palpitations?

Yes. An overactive or underactive thyroid may affect heart rate and rhythm. Blood testing may be recommended.

When should I go to the emergency room?

Emergency evaluation is necessary when palpitations occur with severe chest pain, fainting, severe breathlessness, confusion, or a persistent very fast heartbeat.