Heart palpitations are one of the most common cardiovascular symptoms experienced by adults of all ages. Many people describe palpitations as:
- A racing heartbeat
- Skipped beats
- Fluttering in the chest
- Thumping sensations
- Sudden pounding of the heart
- Irregular heart rhythms
- “Flip-flopping” sensations in the chest
While palpitations are often harmless and may be triggered by stress, caffeine, lack of sleep, or anxiety, they can sometimes indicate an underlying heart condition that requires medical assessment.
In some patients, palpitations may be associated with
- Heart valve disease
- Arrhythmias (abnormal heart rhythms)
- Cardiomyopathy
- Thyroid disease
- Structural heart abnormalities
- Coronary artery disease
- Electrolyte imbalance
An echocardiogram (heart ultrasound scan) is one of the most important investigations used to evaluate whether the heart’s structure and function may be contributing to palpitations.
At London Private Ultrasound – Echocardiogram London, patients can access rapid private cardiac assessments, including echocardiography and heart health screening.
What Are Heart Palpitations?
Palpitations are an awareness of your heartbeat. Normally, people are not consciously aware of their heart beating. However, certain changes in heart rhythm, force of contraction, or heart rate may make the heartbeat more noticeable.
Palpitations may feel like
- Rapid beating
- Irregular beating
- Forceful pounding
- Fluttering
- Pauses followed by stronger beats
They may occur
- During exercise
- At rest
- During emotional stress
- After caffeine or alcohol intake
- At night
- During illness or fever
Some episodes last seconds, while others may continue for minutes or hours.
According to NHS England – Heart Palpitations, palpitations are common and are often harmless, but persistent or associated symptoms should be medically assessed.
How Does the Heart Normally Beat?
The heart contains an electrical conduction system that coordinates each heartbeat.
The heartbeat begins in the
Sinoatrial (SA) Node
Often called the heart’s “natural pacemaker.”
Electrical signals travel through
- The atria (upper chambers)
- The atrioventricular (AV) node
- The ventricles (lower chambers)
This coordinated electrical activity allows the heart to pump blood efficiently throughout the body.
Disruption of this system can lead to abnormal rhythms known as arrhythmias.
What Causes Palpitations?
Palpitations may result from either
- 1. Changes in the electrical activity of the heart, or
- 2. Structural abnormalities affecting the heart muscle or valves.
- Anxiety
- Stress
- Panic attacks
- Excess caffeine
- Alcohol
- Smoking
- Dehydration
- Sleep deprivation
- Certain medications
- Fever
- Hormonal changes
- Pregnancy
- Premature atrial contractions (PACs)
- Premature ventricular contractions (PVCs)
- A pause
- A “thump” in the chest
- Brief fluttering sensations
- Chest pain
- Shortness of breath
- Dizziness
- Blackouts or fainting
- Exercise-induced symptoms
- Family history of sudden cardiac death
- Persistent rapid heart rate
- Known heart disease
- Too fast (tachycardia)
- Too slowly (bradycardia)
- Irregularly
- Stroke
- Heart failure
- Sudden cardiac arrest
- The upper chambers of the heart (atria) beat chaotically
- Electrical signals become disorganised
- The heartbeat becomes irregular and often rapid
- Palpitations
- Breathlessness
- Fatigue
- Dizziness
- Chest discomfort
- Stroke
- Heart failure
- Blood clots
- Reduced cardiac efficiency
- Atrial enlargement
- Valve disease
- Heart muscle function
- Blood flow abnormalities
- Sudden racing heartbeat
- Dizziness
- Sweating
- Breathlessness
- Chest tightness
- Cardiomyopathy
- Previous heart attacks
- Heart muscle scarring
- Inherited heart conditions
- Reduced pumping function
- Enlarged heart chambers
- Thickened heart muscle
- Structural abnormalities
- Heart chambers
- Heart valves
- Heart muscle
- Blood flow
- Pumping function
- Valve disease
- Enlarged heart chambers
- Cardiomyopathy
- Reduced heart pumping function
- Congenital abnormalities
- Pulmonary hypertension
- Fluid around the heart
- Stretching of heart tissue
- Fibrosis (scar tissue formation)
- Chamber enlargement
- Inflammation
- Pressure overload
- Reduced blood supply
- Enlarged atria increase AF risk
- Thickened ventricular walls may predispose to ventricular arrhythmias
- Valve disease can stretch heart chambers
- Cardiomyopathy may create abnormal electrical circuits
- Mitral valve
- Aortic valve
- Tricuspid valve
- Pulmonary valve
- Turbulent blood flow
- Chamber enlargement
- Increased cardiac workload
- Measuring chamber size
- Assessing wall thickness
- Evaluating heart function
- Identifying obstruction to blood flow
- Heart rate
- Cardiac contractility
- Awareness of heartbeat
- Racing heartbeat
- Chest tightness
- Hyperventilation
- Dizziness
- 1. You lie on an examination couch.
- 2. ECG leads may be attached to monitor heart rhythm.
- 3. Ultrasound gel is applied to the chest.
- 4. A probe (transducer) obtains images from multiple angles.
- Painless
- Non-invasive
- Radiation-free
- Usually completed within 20–45 minutes
- Arrhythmias
- Heart rhythm disturbances
- Conduction abnormalities
- Valve disease
- Cardiomyopathy
- Heart failure
- Structural abnormalities
- Holter monitoring
- 24-hour ECG
- Event recorders
- Blood tests
- Thyroid function tests
- Exercise stress tests
- Cardiac MRI
- CT coronary angiography
- Chest pain
- Severe breathlessness
- Collapse
- Loss of consciousness
- Severe dizziness
- Blue lips
- Persistent rapid heart rate
- High blood pressure
- Diabetes
- Smoking
- High cholesterol
- Obesity
- Sedentary lifestyle
- Family history
- Structural heart disease
- Early heart dysfunction
- Arrhythmia risk factors
- Vascular disease
- Valve disease
- Cardiomyopathy
- Heart failure
- Pulmonary hypertension
- Chamber enlargement
- Structural abnormalities associated with arrhythmias
- Dr Pedram Aghaei — Vascular Scientist, SVT reg. SVT 679 · Registered Clinical Technologist, RCT reg. · BMUS
- Dr Hosna Rashidi — BMUS · SVT reg.
Common Benign Causes of Palpitations
Many palpitations are not dangerous.
Common non-serious causes include
Stimulants such as caffeine increase sympathetic nervous system activity, which may temporarily increase heart rate or trigger ectopic beats.
What Are Ectopic Beats?
Ectopic beats are extra heartbeats originating outside the normal electrical pathway.
Types include
These extra beats are extremely common and often harmless.
Patients may experience
An echocardiogram is sometimes recommended if ectopic beats are frequent or if structural heart disease is suspected.
When Can Palpitations Indicate Heart Disease?
Palpitations may sometimes be associated with serious cardiovascular conditions.
Warning signs include
In these cases, further cardiac investigation is important.
What Is an Arrhythmia?
An arrhythmia is an abnormal heart rhythm.
The heart may beat
Some arrhythmias are harmless, while others may increase the risk of
Atrial Fibrillation (AF)
What Is Atrial Fibrillation?
Atrial fibrillation is one of the most common arrhythmias worldwide.
In AF
Symptoms may include
Some patients have no symptoms at all.
Why Is Atrial Fibrillation Important?
AF increases the risk of
According to British Heart Foundation – Atrial Fibrillation, untreated atrial fibrillation significantly increases stroke risk because blood may pool inside the atria and form clots.
An echocardiogram can help assess
Supraventricular Tachycardia (SVT)
SVT refers to rapid heart rhythms arising from the upper chambers of the heart.
Symptoms may include
Episodes may start and stop suddenly.
Echocardiography helps evaluate whether there is associated structural heart disease.
Ventricular Arrhythmias
Abnormal rhythms arising from the ventricles can sometimes be serious.
These may occur in patients with
An echocardiogram can identify
What Is an Echocardiogram?
Book your private heart ultrasound appointment →
An echocardiogram is an ultrasound scan of the heart.
It uses high-frequency sound waves to produce moving images of
Unlike CT scans or X-rays, echocardiography does not involve radiation exposure.
It is considered one of the safest and most informative cardiac investigations.
More information is available at
London Private Ultrasound – Echocardiography Services
Why Is an Echocardiogram Important for Palpitations?
An echocardiogram helps determine whether palpitations may be related to structural heart disease.
The scan can detect
This is important because some arrhythmias are secondary to structural abnormalities within the heart.
Scientific Understanding: How Structural Heart Disease Causes Arrhythmias
The heart’s electrical activity is strongly influenced by the anatomy of the heart muscle and chambers.
Structural abnormalities may disrupt electrical conduction through
For example
Echocardiography allows clinicians to visualise these structural changes directly.
Heart Valve Disease and Palpitations
The heart contains four valves
Valve abnormalities may lead to
Over time, this may trigger arrhythmias.
Mitral valve prolapse, for example, is sometimes associated with palpitations and ectopic beats.
An echocardiogram is considered the primary imaging test for assessing heart valve disease.
Cardiomyopathy and Palpitations
Cardiomyopathy refers to diseases affecting the heart muscle itself.
Dilated Cardiomyopathy
The heart becomes enlarged and weakened.
Hypertrophic Cardiomyopathy
The heart muscle becomes abnormally thickened.
Restrictive Cardiomyopathy
The heart muscle becomes stiff.
These conditions may alter electrical conduction and increase arrhythmia risk.
Echocardiography is essential for
According to American Heart Association – Cardiomyopathy, cardiomyopathy may increase the risk of serious rhythm disturbances.
Can Anxiety Cause Palpitations?
Yes.
Stress hormones such as adrenaline stimulate the sympathetic nervous system, increasing
Panic attacks may produce
However, persistent or concerning symptoms should not automatically be attributed to anxiety without appropriate assessment.
What Happens During an Echocardiogram?
At London Private Ultrasound – Heart Health Check London, echocardiography is performed using specialised cardiac ultrasound equipment.
During the scan
The scan is
What Can an Echocardiogram Show?
An echocardiogram may assess
Ejection Fraction
Measures how effectively the heart pumps blood.
Valve Function
Identifies narrowing or leakage.
Chamber Size
Detects enlargement of the atria or ventricles.
Wall Thickness
Can identify hypertrophic cardiomyopathy.
Blood Flow Patterns
Uses Doppler imaging to assess blood movement.
Pulmonary Pressure
Can estimate pressure in the pulmonary arteries.
Congenital Heart Disease
Detects structural abnormalities present from birth.
ECG vs Echocardiogram
ECG (Electrocardiogram)
Measures the electrical activity of the heart.
Useful for
Echocardiogram
Assesses the structure and function of the heart.
Useful for
These tests often complement one another.
Additional Tests Sometimes Used for Palpitations
Depending on symptoms, doctors may also recommend
When Should You Seek Urgent Medical Attention?
Seek urgent medical help immediately if palpitations are associated with
These symptoms may indicate a serious cardiac emergency.
Heart Health Screening and Prevention
Book your private heart ultrasound appointment →
Cardiovascular disease remains one of the leading causes of death globally.
Risk factors include
Preventive cardiovascular screening may help identify
You can book heart health check here
London Private Ultrasound – Heart Screening Services
Final Thoughts
Heart palpitations are common and are often harmless, particularly when related to stress, caffeine, or temporary physiological changes. However, persistent, worsening, or symptomatic palpitations may sometimes indicate underlying heart disease.
An echocardiogram is one of the most important investigations for evaluating whether structural heart abnormalities may be contributing to symptoms.
Echocardiography can help diagnose
Early diagnosis and assessment may improve treatment options and help reduce long-term cardiovascular risk.
Book a private echocardiogram in London
Patients with palpitations, irregular heartbeat, chest discomfort, breathlessness, dizziness, or risk factors for heart disease can book a private echocardiogram directly with London Private Ultrasound.
Book Echocardiogram OnlineFrequently asked questions
Can an echocardiogram detect the cause of palpitations?
It can identify structural heart problems that may contribute to palpitations, such as valve disease, enlarged chambers, cardiomyopathy or reduced pumping function. ECG or Holter monitoring may also be needed to record the rhythm itself.
Is an echocardiogram the same as an ECG?
No. An ECG measures the electrical activity of the heart, while an echocardiogram uses ultrasound to assess heart structure, valves and pumping function. They often complement each other.
When should palpitations be checked?
Palpitations should be assessed when they are persistent, worsening, exercise-related, or associated with chest pain, breathlessness, dizziness, fainting, or a family history of sudden cardiac death.
Can anxiety cause palpitations?
Yes. Anxiety, stress, caffeine, alcohol and poor sleep can trigger palpitations. However, new or concerning symptoms should not automatically be dismissed as anxiety without medical assessment.
Article preparation and clinical review
This patient information page was prepared with AI-assisted editorial support and reviewed for clinical accuracy by:
This article is intended for general patient information only and does not replace a medical consultation. If you experience severe or worsening palpitations, chest pain, shortness of breath, fainting, severe dizziness, or symptoms suggestive of a heart attack or serious cardiac rhythm disturbance, please seek urgent medical attention immediately or contact emergency services.