How Can I Tell if My Palpitations are Due to Stress or a Heart Condition?

By Dr Reginald Liew

It’s common to feel your heart flutter, skip a beat, or pound unexpectedly. Most of the time, heart palpitations are harmless. But occasionally, they may hint at an underlying cardiac issue. So how do you tell when to shrug it off, or when to seek medical help?

What are palpitations?

Heart palpitations describe the feeling that your heart is racing, fluttering, skipping a beat, or pounding unexpectedly. You may notice it in your chest, neck, or throat – sometimes during stressful moments, after caffeine, or even at rest.

In most cases, palpitations are harmless and temporary. However, they can occasionally signal an underlying heart rhythm issue that deserves medical evaluation.

Common Causes of Palpitations

Heart palpitations can arise from everyday factors as well as medical conditions. The following are some common triggers:

• Emotional stress or anxiety
• Caffeine, alcohol, or nicotine intake
• Dehydration or low blood sugar
• Lack of sleep or fatigue
• Fever or infections
• Hormonal changes (e.g. during menstruation or menopause)
• Thyroid disorders or anemia

However, persistent or severe palpitations may indicate a cardiac cause such as:

• Irregular heart rhythms (arrhythmias)
• Heart valve abnormalities
• Cardiomyopathies (heart muscle conditions)
• Coronary artery disease

Stress vs. Heart Condition – How to Differentiate

If your heart is fluttering, ask yourself these questions:

Tip:

If you can identify a clear trigger, e.g. anxiety, caffeine, or exertion – your palpitations may be benign. If they occur without reason, or cause fainting or chest discomfort, it’s best to consult a heart specialist.

When to See a Cardiologist in Singapore

Seek medical advice promptly if you experience:

• Chest pain or tightness
• Dizziness, fainting, or shortness of breath
• Persistent palpitations lasting over 20 minutes
• Known heart disease, diabetes, or high blood pressure

A cardiologist can help determine whether your palpitations are stress-induced or due to an arrhythmia (abnormal heart rhythm).

At Harley Street Heart & Vascular Centre, diagnostic options may include:

• Electrocardiogram (ECG) – to record electrical heart activity
• Echocardiogram – ultrasound to check heart function and structure
• Ambulatory ECG Monitoring (e.g. Holter or event recorder) – continuous monitoring for 24 hours or more
• Blood Tests – to assess thyroid function, electrolytes, and blood sugar levels

Managing Benign Palpitations

If your palpitations are stress-related or lifestyle-induced, these habits can help reduce their frequency:

• Practice deep breathing or mindfulness exercises
• Limit caffeine, alcohol, and nicotine
• Stay well-hydrated
• Maintain a consistent sleep routine
• Engage in light physical activity
• Manage emotional stress through relaxation or counselling

Even if your symptoms are mild, routine heart check-ups can provide peace of mind, especially if you have a family history of heart disease.

Key Takeaway

Not all heart flutters are dangerous – but not all are harmless either.
If your palpitations are frequent, prolonged, or accompanied by discomfort, it’s wise to get evaluated early. Identifying the cause can prevent complications and give you clarity on how to manage your heart health.

About Harley Street Heart & Vascular Centre

Harley Street Heart & Vascular Centre is a leading cardiac clinic in Singapore, offering comprehensive care for patients with heart rhythm disorders, coronary artery disease, and other cardiovascular conditions.

Our team of experienced cardiologists – Dr Rohit Khurana, Dr Reginald Liew, Dr Michael MacDonald and Dr Peter Ting provide patient-centred cardiac care in a calm, professional environment. Need a second opinion? Schedule an appointment today.