Palpitations Over 65: When to See a Cardiac Specialist

Palpitations Over 65: When to See a Cardiac Specialist

Heart palpitations are common at any age, but they deserve extra attention after 65. As we get older, the heart and blood vessels change, and medical conditions or medications can affect heart rhythm. Many palpitations are harmless, but some can signal a heart rhythm problem that needs expert care.

This guide explains what heart palpitations are, why they happen more often after 65, when they are usually benign, and when it's important to see a cardiac specialist. The goal is to inform and empower you—without causing unnecessary worry.

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What Are Heart Palpitations?

Heart palpitations are the sensation of being aware of your heartbeat. People describe them in different ways, such as:

• A fluttering or pounding in the chest
• A racing or irregular heartbeat
• A skipped beat or brief pause
• A thumping feeling in the throat or neck

Palpitations can last seconds, minutes, or longer, and they may come and go. They can occur at rest, during activity, or while lying down.

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Why Heart Palpitations Are More Common After 65

As we age, several factors make heart palpitations more likely:

• Normal aging of the heart's electrical system, which can slow or misfire
• Higher rates of chronic conditions, such as high blood pressure, diabetes, and heart disease
• Medication effects, including drugs for blood pressure, asthma, thyroid disease, or mood disorders
• Changes in hydration and electrolytes, which affect heart rhythm
• Increased sensitivity to caffeine, alcohol, or stress

Most of these causes are manageable. However, age also increases the risk of more serious rhythm disorders, which is why symptoms should not be ignored.

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Common Causes of Heart Palpitations in Older Adults

Often Benign Causes

These are common and usually not dangerous, especially if symptoms are mild and brief:

• Premature atrial or ventricular contractions (extra beats)
• Stress, anxiety, or emotional upset
• Caffeine or alcohol
• Dehydration
• Fever or infection
• Poor sleep

Many people experience these types of heart palpitations occasionally and never develop heart disease.

Potentially Serious Causes

Some palpitations are related to heart rhythm disorders that may require specialist care:

• Atrial fibrillation (AFib) – irregular rhythm that raises stroke risk
• Supraventricular tachycardia (SVT) – sudden episodes of fast heartbeat
• Ventricular arrhythmias – uncommon but potentially dangerous
• Bradycardia (slow heart rhythm) due to conduction disease
• Heart disease, including prior heart attack or heart failure

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When Are Heart Palpitations Usually Less Concerning?

Heart palpitations are more likely to be benign when they:

• Last only a few seconds
• Occur rarely
• Stop on their own
• Happen during stress or caffeine use
• Are not accompanied by other symptoms

If your palpitations fit this pattern, your primary care doctor may be able to evaluate and reassure you without specialist referral.

To help identify whether your symptoms may be related to Benign Arrhythmias (Palpitations), you can use a free AI-powered symptom checker that provides personalized insights based on your specific symptoms before your appointment.

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Warning Signs That Should Not Be Ignored

It's important not to "tough it out" if heart palpitations come with concerning symptoms. Speak to a doctor promptly if palpitations are accompanied by:

• Chest pain or pressure
• Shortness of breath
• Dizziness or lightheadedness
• Fainting or near-fainting
• Sudden weakness or confusion
• New difficulty exercising
• Swelling in the legs or ankles

These symptoms can signal reduced blood flow to the brain or heart and may require urgent evaluation.

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When to See a Cardiac Specialist (Cardiologist)

You should consider seeing a cardiac specialist if:

• Heart palpitations are frequent or worsening
• Episodes last more than a few minutes
• You have a history of heart disease or stroke
• You've been told you have an abnormal EKG
• Palpitations occur with minimal activity or at rest
• You are over 65 and symptoms are new or unexplained

A cardiologist specializes in diagnosing and managing heart rhythm disorders and can determine whether your palpitations are harmless or require treatment.

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What a Cardiac Specialist May Do

A cardiology evaluation is usually straightforward and focused on clarity—not alarm.

Common Tests Include:

• Electrocardiogram (ECG/EKG): A snapshot of heart rhythm
• Holter or event monitor: Records rhythm over days or weeks
• Blood tests: Check thyroid levels, electrolytes, and anemia
• Echocardiogram: Ultrasound to assess heart structure and function
• Stress testing: Evaluates rhythm during activity (if appropriate)

These tests help identify whether heart palpitations are benign or linked to a treatable condition.

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Treatment Options for Heart Palpitations

Treatment depends on the cause and severity. Many people need no treatment at all beyond reassurance and lifestyle changes.

Possible Approaches:

• Adjusting medications
• Treating underlying conditions (such as thyroid disease)
• Reducing caffeine or alcohol
• Improving sleep and hydration
• Stress management techniques
• Medications to control heart rhythm or rate
• In select cases, procedures such as catheter ablation

Your cardiologist will recommend the least invasive option that keeps you safe and comfortable.

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Practical Steps You Can Take Now

If you're experiencing heart palpitations, consider these steps:

• Keep a symptom diary (when it happens, how long it lasts, what you were doing)
• Note triggers like caffeine, dehydration, or stress
• Bring a full medication list to appointments
• Don't stop prescribed medications without medical advice
• Use a free Benign Arrhythmias (Palpitations) symptom checker to better understand your symptoms and prepare informed questions for your doctor

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A Reassuring but Honest Perspective

Most heart palpitations in adults over 65 are not immediately dangerous, and many turn out to be benign. At the same time, age increases the chance that palpitations reflect a condition that benefits from early detection.

The key is not to panic—but not to ignore symptoms either.

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Final Takeaway

Heart palpitations after 65 are common and often manageable. Pay attention to patterns, take associated symptoms seriously, and speak to a doctor about anything that feels new, severe, or concerning—especially if symptoms could be life threatening.

Early evaluation brings clarity, reassurance, and—when needed—effective treatment.