Key takeaways:
- Palpitations are a symptom, a feeling that your heart is racing, fluttering, or skipping a beat
- Arrhythmias are actual irregularities in the heart’s rhythm, detectable on medical tests
- Not all palpitations mean you have an arrhythmia
- Some arrhythmias occur without noticeable symptoms
- A doctor can help determine if further testing is needed
It’s a sensation that can catch you off guard, your heart suddenly beats faster, skips a beat, or feels like it’s fluttering in your chest. Many people experience this at some point and wonder: Is this something serious?
The answer isn’t always straightforward. While palpitations can sometimes be linked to a heart rhythm disorder, they can also occur in people with completely healthy hearts. Understanding the difference between palpitations and arrhythmias can help you make informed decisions about when to seek medical advice.
What Are Palpitations?
Palpitations are not a condition themselves. Rather, they are a subjective experience, such as how your heartbeat feels. People describe them as:
- Pounding in the chest
- A racing or fast heartbeat
- Skipped beats
- Fluttering or flip-flop sensations
- A strong awareness of the heartbeat, especially at rest
These sensations can occur with or without physical exertion and may last a few seconds or several minutes. Common triggers include:
- Stress or anxiety
- Caffeine or alcohol
- Lack of sleep
- Intense exercise
- Fever or dehydration
- Hormonal changes (e.g. during pregnancy or menstruation)
In many cases, palpitations are short-lived and harmless, especially when they occur infrequently and resolve on their own.
What Are Arrhythmias?
Arrhythmias refer to actual changes in the heart’s electrical rhythm. These can include:
- Tachycardia – heart beats too fast
- Bradycardia – heart beats too slowly
- Irregular rhythms – such as atrial fibrillation or extra beats
Some arrhythmias are harmless, while others may require monitoring or treatment, especially if they affect how efficiently the heart pumps blood.
Unlike palpitations, arrhythmias can occur without noticeable symptoms, which is why certain cases are only picked up during routine ECGs or monitoring.
When Do They Overlap?
Palpitations can sometimes be a symptom of an arrhythmia, but not always. For example, someone with atrial fibrillation may feel a racing or irregular heartbeat, while another person with the same condition may feel nothing at all.
Conversely, many people with frequent palpitations, especially younger adults, may have normal heart rhythm on testing. In such cases, the sensation is real, but the heart’s electrical system is not showing signs of dysfunction.
That’s why it’s important to investigate persistent or bothersome symptoms rather than self-diagnose.
When Should You See a Doctor?
You should consult a healthcare provider if:
- Palpitations are happening often or last longer than a few minutes
- They occur at rest or wake you from sleep
- They are accompanied by chest pain, dizziness, fainting, or shortness of breath
- You have a known heart condition or family history of heart rhythm disorders
What Tests May Be Recommended?
Your doctor may suggest:
- Electrocardiogram (ECG) – a short test to check heart rhythm at the time of the visit
- Ambulatory ECG monitoring – wearable devices (e.g., Holter monitor) that record your heart’s activity over 24–48 hours or longer
- Echocardiography – an ultrasound of the heart to assess structure and function
- Blood tests – to check for thyroid imbalance, anaemia, or electrolyte disturbances
You Don’t Have to Guess, Get Checked
Not every skipped beat is dangerous, and not every flutter needs immediate intervention. But if you’re unsure, the best step is to get it checked. At Heart Matters Medical Centre, we offer comprehensive evaluation for palpitations and arrhythmias, including ECG, Holter monitoring, and other diagnostic tests.
If you’ve been feeling irregular heartbeats or are concerned about your heart rhythm, speak with Dr Dinesh Nair and our team to find out more.
📍 Located at Mount Elizabeth Novena Specialist Centre
📞 Call +65 6339 1991
📧 info@heartmatters.com.sg
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