Palpitations are the awareness of one's own heartbeat — often described as fluttering, racing, pounding, or missed beats. Most are benign, but some require investigation.
Heart palpitations are the subjective awareness of your heartbeat — a sensation that your heart is racing, fluttering, pounding, skipping, or beating irregularly. They are extremely common: nearly everyone experiences them at some point, most commonly triggered by caffeine, stress, anxiety, exercise, or stimulant medications. In most cases, palpitations are benign and self-limiting.
However, palpitations can occasionally indicate significant cardiac arrhythmias that require investigation. Common arrhythmias include atrial fibrillation (AF) — an irregular, often rapid heart rate that increases stroke risk — supraventricular tachycardia (SVT), and ventricular arrhythmias. In Korea, cardiologists and electrophysiologists at major hospitals such as Samsung Medical Center and Asan Medical Center, and private cardiac clinics, have access to Holter monitoring, event recorders, echocardiography, and electrophysiology studies to evaluate palpitations.
Non-cardiac causes of palpitations are also important to consider: thyroid disease (hyperthyroidism in particular causes palpitations), anaemia, dehydration, fever, anxiety, and stimulant use — caffeine and energy drinks, popular among Korea's younger population, and some medications. The evaluation of palpitations begins with a 12-lead ECG, which captures the heart rhythm at rest. If palpitations are infrequent, a 24-hour or 7-day Holter monitor or wearable cardiac device may be needed to capture the rhythm during episodes.
Key Points
- Most palpitations are benign — triggered by caffeine, stress, or anxiety
- Atrial fibrillation (AF) is the most important arrhythmia to exclude
- Energy drinks and excessive caffeine are common triggers, especially among younger adults
- 12-lead ECG is the first-line investigation
- Holter monitoring captures intermittent arrhythmias
- Palpitations with syncope, chest pain, or breathlessness — emergency
Causes & Risk Factors
- Anxiety and stress — adrenaline stimulates heart rate
- Caffeine and energy drinks — direct cardiac stimulant
- Atrial fibrillation — irregular atrial rhythm, increases stroke risk
- SVT (supraventricular tachycardia) — paroxysmal rapid heart rate
- Hyperthyroidism — excess thyroid hormone accelerates heart rate
- Anaemia and dehydration — increased heart rate to compensate
When to See a Doctor
- Palpitations with chest pain, breathlessness, or fainting — call 119
- Palpitations lasting more than 30 minutes
- Palpitations with dizziness or near-fainting (pre-syncope)
- New palpitations in someone over 40 or with heart disease
- Irregular heartbeat felt as long pauses then strong beats
For emergencies in Korea, call 119
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This content is published for educational purposes only. For accurate diagnosis and personalised treatment, consult a licensed KMA physician in Korea.
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Medical Disclaimer
This article is published by DoctorsInKorea.com for educational and informational purposes only. It does not replace a professional clinical evaluation by a licensed healthcare provider. For accurate medical diagnosis and personalised treatment paths, please book an appointment with a licensed KMA physician. For immediate life-threatening medical emergencies in Korea, please call 119.
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Last reviewed: March 1, 2025