Irregular heartbeat

An irregular heartbeat (palpitations or rhythm disturbance) is a common symptom. Below is general information on how people commonly notice it, frequent triggers, warning signs that need urgent attention, and which clinicians may be involved in evaluation.

How it may feel: common sensations

An irregular heartbeat can be felt as rapid pounding, fluttering, skipped beats, extra beats or a sudden racing. Some people describe brief pauses or a strong thump. If these sensations occur with dizziness, breathlessness, fainting or chest discomfort, prompt assessment may be needed.

Common triggers and lifestyle links

Many factors can bring on palpitations: caffeine or alcohol, high stress or anxiety, intense exercise, poor sleep, some medications, and disturbances in electrolytes or thyroid function. Cardiac rhythm disorders can also be the primary cause. Tracking when episodes happen and any associated activities or substances helps clinicians identify likely triggers.

When to seek urgent care

If an irregular heartbeat is accompanied by severe chest pain, sudden difficulty breathing, fainting or near‑fainting, severe dizziness or confusion, seek emergency medical care right away. These signs can indicate a potentially serious problem requiring immediate evaluation.

How evaluation usually proceeds and which specialists to see

Initial assessment often begins with primary care or internal medicine; patients may be referred to cardiology if needed. Common tests include a resting ECG, ambulatory monitoring (24–48 hour Holter or longer event monitor), echocardiography and blood tests such as electrolytes and thyroid function. The clinician will recommend tests based on symptom pattern and exam findings.

Prepare for your appointment: what to track

Note when episodes start, how long they last, any likely triggers (caffeine, alcohol, stress, exercise), accompanying symptoms, and all prescription or over‑the‑counter medicines. A simple diary of episodes can speed diagnosis and guide appropriate specialist referral.

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