Sitemap

OTHER SYMPTOMS & DIAGNOSIS

ANGINA & HEART ATTACK (MYOCARDIAL INFARCTION)

PALPITATION

ATRIAL FIBRILLATION (AF)

OTHER HEART RHYTHM PROBLEMS

HEART VALVE DISEASE

BLACKOUTS/SYNCOPE

BREATHLESSNESS/HEART FAILURE

BLOOD PRESSURE (HYPERTENSION)

CHOLESTEROL

Dr. Richard Mansfield

Dr. Richard Mansfield
BSc (Hons) MB ChB MD FRCP FESC
CONSULTANT CARDIOLOGIST

Note: I am happy to answer general questions regarding the content of this website, but I cannot give clinical advice. Such requests will not be answered.

Palpitation

Palpitation is a common symptom that accounts for around 20-25% of all referrals to cardiac outpatient clinics and most people experience this at some time in their lives. Palpitation does not mean that there is necessarily an underlying problem with the heart.

Is it serious?

In the vast majority of patients palpitation is not serious although it does lead to considerable anxiety and concern.

Is palpitation all due to the same thing?

No.

Palpitation may be due to an awareness of the normal heartbeat. This is common and occurs when frightened or nervous.

A common cause of palpitation is the presence of "extra beats" or ectopics. These may occur in the chambers at the top of the heart (atria) or in the bottom chambers (ventricles). They are often noticed as a 'lurch' or 'thump' in the chest or may be experienced as a "missed beat". They are generally quite safe but if there is underlying heart disease then they may be more significant.

Palpitation may also occur when the heart is beating fast and this is known as tachycardia. There are a number of different reasons why the heartbeat may be fast and may be due to abnormal electrical currents in the heart.

Bradycardia is the opposite of tachycardia and means that the heart is beating slowly. This may also cause palpitation as well as breathlessness and fatigue.

What tests are usually carried out for palpitation?

Patients with palpitation are likely to undergo a series of cardiac investigations including blood tests and in particular a test of the thyroid gland. All will have an ECG and many will have a period of heart rhythm monitoring. The duration of heart rhythm monitoring will be determined by the frequency of palpitation. In some cases this may reveal the cause for palpitation but in patients whose symptoms are quite infrequent or occur over long periods this may not be possible. If there is concern regarding the cause of palpitation then, particularly in situations where it is associated with loss of consciousness, it may be appropriate to implant a loop recorder under the skin, which can monitor the heart rhythm for up to 3 years. In some circumstances it may be necessary for patients to have an electrophysiological study. This procedure, carried out under local anaesthetic and some sedation, involves the placement of a number of wires in the heart. Attempts are made to stimulate the abnormal heart rhythm in the hope that the cause of palpitation can be documented and appropriate treatment offered.

Are there any simple measures that can help palpitation?

Whatever the cause of palpitation, the symptoms may be helped by the avoidance of alcohol, caffeine and chocolate. This may be all that is necessary but for some patients tablets treatment may be needed. For a small proportion of patients with tachycardia that does not respond to tablet treatment it may be necessary to have further tests and ablation therapy.