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Palpitations

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What are palpitations?

Heart palpitations are an unpleasant feeling of the beating of the heart. This can include the feeling of a rapid, fluttering or pounding heartbeat. Palpitations may be triggered by exercise, medication or stress.

Most people experience heart palpitations at some point in their life. On their own, palpitations are not life-threatening and usually only last a few seconds. In rare cases, palpitations may be a symptom of a more serious heart condition.

Signs and symptoms

Palpitations can be described as racing of the heart, skipping of heartbeats or fluttering. It can be temporary or persistent.

It can be associated with:

Heart palpitations may be felt as racing, fluttering or skipping of heartbeats. 

Associated symptoms

There are many symptoms that can occur with palpitations; however, dizziness and fainting may indicate an underlying cardiac cause.

Causes

The following medical conditions that alter the electrical rhythm of the heart (arrhythmia) can cause palpitations:

Atrial fibrillation

Atrial fibrillation is an irregularity in the heart's rhythm. During atrial fibrillation, the heart beats fast and abnormally.

Supraventricular tachycardia

Supraventricular tachycardia is a condition that causes a high heart rate, often above 150 beats per minute, usually due to a structural problem with the electrical system of the heart.

Premature beats

Premature beats occur when the heart is triggered to contract before the next heartbeat is due. Many people with premature beats do not need any specific treatment.

Non-sustained ventricular tachycardia

Non-sustained ventricular tachycardia is a very fast heart rhythm that originates in the lower chambers of the heart, known as the ventricles. If this type of irregular heartbeat persists, then it is called sustained ventricular tachycardia and this can be a potentially life-threatening rhythm.

Other causes

Numerous other conditions and medications can also cause palpitations. These include:

Triggers

Some factors that can trigger palpitations include:

Methods for diagnosis

To help diagnose heart palpitations, your doctor may conduct a physical examination - including listening to your heart with a stethoscope - and ask you about your current lifestyle, diet and medications. You will also be asked how often and when the palpitations occur. Some other tests may be done to ensure you do not have a more serious condition. These tests include:

Electrocardiography

During electrocardiography (ECG), electrodes are attached to your chest while you lie on your back. These record your heart's electrical activity from different angles. This test is used to determine if there are any abnormalities in your heart's rhythm. To see how your heart responds to stress, an electrocardiogram can be performed while you jog on a treadmill.

An electrocardiography (ECG) procedure. 

Echocardiography

Echocardiography, also known as an 'echo', uses ultrasound waves to create an image of the heart. It allows your doctor to see the size of your heart and how well it is working. This may include information on how hard the heart is pumping blood, whether the heart valves are leaking and any areas of damage caused by events such as a heart attack. To determine how the heart is working under stress, rather than resting conditions, echocardiography can be performed after exercise.

Holter monitor

A Holter monitor is a portable version of electrocardiography that records the electrical activity and heart rate over time (e.g., 24 hours). It is worn under your clothing without causing you discomfort.

Event recorder

An event recorder is similar to a Holter monitor, with the exception that it only transmits signals when you are experiencing symptoms. An event recorder may be worn for up to a month and is useful when trying to diagnose rhythm disturbances that occur at unpredictable times.

Chest X-ray

A chest X-ray will give an indication of the condition of your heart and lungs. It may also help to identify issues other than palpitations to explain your signs and symptoms.

Blood tests

Your doctor may also want to do blood tests to examine the level of glucose, amount of hormones secreted by the thyroid or, a blood cell count to diagnose a condition such as anemia.

Types of treatment

Heart palpitations often do not require any treatment, unless your palpitations are caused by a more serious heart condition. When no treatment is required, your doctor may simply recommend that you avoid the activities that cause your palpitations. In the rarer cases when palpitations are caused by a more serious condition, such as an irregular heartbeat, the treatment will focus on improving this condition.

Prognosis

Almost everyone experiences palpitations at some time in their life. For most people it is a normal occurrence and will go away on its own. There is a low risk that you may have a more serious medical condition.

Prevention

To help prevent palpitations, you may try to avoid activities or stresses that might cause you to have them. Some common causes include anxiety or panic attacks and having too much caffeine or alcohol.

References

  1. Heart arrhythmias and palpitations. Better Health Channel. Accessed 7 July 2014 from link here
  2. Heart palpitations Definition - Diseases and Conditions - Mayo Clinic. Accessed 7 July 2014 from link here
  3. Palpitations. Accessed 7 July 2014 from link here
  4. Thyroid gland. Better Health Channel. Accessed 7 July 2014 from link here

10 Most frequently asked questions (FAQs)

What are palpitations?
Heart palpitations are an unpleasant feeling of the beating of the heart. This can include the feeling of a rapid, fluttering or pounding heartbeat.
What are the symptoms of palpitations?
Heart palpitations can include racing of the heart, skipping of heartbeats and fluttering, flopping or pounding of the heart. The palpitations can be felt in your chest, throat and neck.
What causes palpitations?
The causes of heart palpitations are varied. These may be stress, anxiety or another strong emotional response, strenuous exercise, caffeine, alcohol, nicotine or medications containing pseudoephedrine (some cold and cough medicines) and salbutamol (used for asthma). Medical conditions that may cause palpitations include previous heart problems (heart valve problems, heart defect at birth or heart attack); high levels of thyroid hormone; low blood sugar levels and high output of the heart such as during pregnancy, anemia or fever.
Who gets palpitations?
Palpitations affect almost everyone at some stage of their life. Some medical conditions that can cause palpitations include: previous heart problems (heart valve problems, heart defect at birth or heart attack); psychiatric disorders (e.g., panic attacks, anxiety and depression); high levels of thyroid hormone (hyperthyroidism); low blood sugar levels; high output of the heart in situations such as pregnancy, anemia or fever, and; medications such as pseudoephedrine (some cold and cough medicines) and salbutamol (used for asthma).
How are palpitations diagnosed?
To help diagnose heart palpitations, your doctor will try to identify the cause of your palpitations. This may include a physical examination, questions about your lifestyle and medications. You may also be asked how often and when the palpitations occur. your doctor will listen to your heart using a stethoscope. Some other tests may be performed to ensure you do not have a more serious condition; these tests include electrocardiography, echocardiography, a Holter monitor, an event recorder and a chest X-ray.
Could palpitations be a warning sign for something else?
In rare cases, you may be experiencing palpitations because you have a more serious heart condition or complication.
How are palpitations treated?
Heart palpitations often do not require any treatment, unless your palpitations are caused by a more serious heart condition. When no treatment is required, your doctor may simply recommend that you avoid the activities that cause your palpitations. In the rarer cases when palpitations are caused by a more serious condition, such as some arrhythmias, the treatment will focus on improving this condition.
Can palpitations be cured?
Palpitations will generally resolve when you reduce or remove the triggers that cause them. If they are frequent and persistent, you may have a more serious underlying heart condition.
Will palpitations clear on their own?
Yes, almost everyone experiences palpitations and they generally stop on their own. In rare cases where they do not stop, you may require tests to see if you have a more serious heart condition.
What can be done at home to treat palpitations?
To help prevent palpitations, you may try to avoid activities or lifestyle choices that are a likely cause. Some of these include stressful situations, which can lead to anxiety or panic attacks, drinking too much caffeine or alcohol and vigorous exercise.

Related topics

Supraventricular tachycardia (SVT)

Supraventricular tachycardia is an abnormally rapid heart rhythm that can be in excess of 200 beats per minute. It is caused by an interruption to the heart’s normal electrical circuit. Treatment options aim to restore this electrical activity.

Atrial fibrillation

Atrial fibrillation is an irregularity in the heart’s rhythm. The condition causes several potential complications that can have serious consequences. The heart rate can become very fast, or a clot can form within the heart, leading to a stroke.

Angina

Angina refers to a feeling of pressure, tightness or pain in the chest which occurs when there is poor blood flow to the heart muscle. This is usually the result of cholesterol and fat deposits narrowing the coronary arteries which supply the heart muscle. Lifestyle changes, medications and/or surgery can treat the condition.

Carcinoid syndrome

Carcinoid syndrome describes a set of symptoms caused by a carcinoid tumour that secretes various naturally-occurring chemicals, such as serotonin, histamine and prostaglandins. Symptoms vary, but can include flushing, diarrhoea and wheezing.

About this article

Title: Palpitations

Author: Dr Bow Tauro PhD, BSc (Hons)

First Published: 17 Sep 2014

Last reviewed: 17 Jan 2022

Category: Information on Palpitations

Average rating: 4.2 out of 5 (1399 votes)

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