When Your Heart Skips, Races, or Pounds
A sudden awareness of your heartbeat. A fluttering in your chest. A sensation that your heart has skipped a beat or is pounding out of your ribcage. Heart palpitations are alarming – and they are one of the most common reasons patients visit our practice in Zürich Seefeld. The good news is that in the majority of cases, palpitations are benign. The challenge is distinguishing harmless skipped beats from something that requires attention.
What Are Palpitations?
Palpitations are the subjective sensation of your heartbeat – feeling it pound, flutter, race, or skip. Normally, you are unaware of your heartbeat. When you become conscious of it, especially if the rhythm feels abnormal, that is a palpitation. They can last seconds or minutes and may occur at rest, during activity, or when lying down.
Common Causes of Palpitations
Premature beats (ectopic beats): The most common cause. Extra beats originating from the atria (PACs) or ventricles (PVCs) are almost always benign. They feel like a “skip” or “flip” and are often followed by a stronger-than-usual beat. Nearly everyone has them; most people simply do not notice.
Stress and anxiety: Adrenaline and cortisol increase heart rate and can trigger ectopic beats. Panic attacks classically cause intense palpitations alongside breathlessness, sweating, and a sense of impending doom.
Caffeine, alcohol, and stimulants: These are common triggers. Even moderate caffeine intake can provoke palpitations in sensitive individuals.
Thyroid dysfunction: Hyperthyroidism is a classic cause of tachycardia and palpitations. Even subclinical hyperthyroidism can affect heart rhythm.
Iron deficiency: Anaemia or low iron forces the heart to work harder to deliver oxygen, causing a faster heart rate and palpitations.
Magnesium and potassium deficiency: These electrolytes are essential for stable cardiac rhythm. Deficiency increases the likelihood of ectopic beats and arrhythmias.
Hormonal changes: Many women experience palpitations during perimenopause, PMS, or pregnancy due to hormonal fluctuations affecting autonomic tone and electrolyte balance.
Arrhythmias: Atrial fibrillation, supraventricular tachycardia (SVT), and other arrhythmias cause sustained palpitations that may require specific treatment.
When Should You Worry?
Seek prompt medical evaluation if palpitations are accompanied by chest pain, breathlessness, dizziness, fainting, or if they last for sustained periods (minutes to hours). A family history of sudden cardiac death or cardiomyopathy also warrants thorough investigation.
How We Investigate
I perform a resting ECG, check thyroid function, full blood count, iron studies, electrolytes (magnesium, potassium, calcium), and blood sugar. If palpitations are intermittent, I may arrange a 24-hour or 7-day Holter monitor or an event recorder to capture the rhythm during symptoms. Echocardiography is warranted if structural heart disease is suspected.
What We Do: Addressing Palpitations at Their Source
Reassurance when appropriate: For benign ectopic beats, understanding what they are and that they are harmless is often the most effective treatment. Anxiety about palpitations frequently makes them worse.
Correct nutrient deficiencies: Magnesium supplementation alone can dramatically reduce premature beats. Iron correction resolves anaemia-driven tachycardia.
Thyroid optimisation: Treating hyperthyroidism or adjusting thyroid medication doses when over-replacement is the cause.
Lifestyle modifications: Identifying and reducing triggers – caffeine, alcohol, sleep deprivation, and stress.
Autonomic nervous system support: Vagal toning techniques, breathing exercises, and stress management for autonomically mediated palpitations.
Cardiology referral: When arrhythmias are identified that require specialist management, I coordinate care with trusted cardiologists.
Conclusion
Heart palpitations are usually benign but always deserve investigation to rule out significant causes. A thorough workup provides both answers and reassurance. If palpitations are troubling you, book an evaluation at our practice in Zürich Seefeld – we will get to the bottom of it.
