As a rule, a person is not conscious of the beating of the heart. Abnormal heart rhythm (ARRHYTHMIA) may cause palpitations. Sudden emotions, such as fright, or overuse of tobacco, tea, coffee or alcohol may bring it on. Sometimes it is a sign of heart disease.

There may simply be a fluttering of the heart and a feeling of faintness, or the heart may be felt pounding and the arteries throbbing, causing great distress. The subject may be conscious of the heart missing beats.

Although these symptoms can be unpleasant, they do not necessarily signify serious disease. Moderate exercise is a good thing. If the person is a smoker, he or she should stop. Tea, coffee, alcohol or other stimulants should be taken sparingly. If symptoms persist or are severe, it may be necessary and reassuring to rule out any underlying disorder by investigations such as an exercise ECG; such underlying disorders might include hyperthyroidism (see THYROID GLAND, DISEASES OF). If an arrhythmia is present, it can be classified and appropriate treatment prescribed.