How Are Heart Palpitations Diagnosed?
DiagnosisA doctor will first discuss your symptoms and perform a physical exam to diagnose heart palpitations. The doctor will listen to your heart for signs of underlying medical conditions and may ask questions about your medical history.
Blood tests can also be performed to check for anemia, vitamin and mineral deficiencies, abnormal hormone levels, or infections that may cause palpitations. If these tests suggest that an underlying heart condition is causing the palpitations, your doctor will conduct further tests to diagnose the issue.
Diagnostic tests can include:
- Electrocardiogram - Otherwise known as an EKG or ECG, this test provides an easy, painless way for a doctor to check a patient’s heart activity. Electrode sensors are placed on the chest and sometimes the arms and legs. The electrodes are connected to a device that displays results regarding heart activity. It can show if a heart is beating too quickly or too slowly.
- Holter monitoring - A patient wears a portable EKG device that records heart rhythm and rate daily. This device can detect palpitations that did not occur during an electrocardiogram test.
- Event monitor recording - Utilizes a device that can be worn for about a month. The patient presses a button when heart palpitation symptoms arise, causing the device to record heart activity. This is useful if palpitations are experienced irregularly (not daily or weekly).
- Echocardiogram - This noninvasive test does not use radiation to test the heart’s structure and function. A doctor will use a wand-like instrument that emits ultrasound waves to produce computerized images of the heart in motion. This enables the doctor to detect structural or blood flow issues within the heart.
Based on your test results, your doctor may need to perform additional tests such as stress tests, urine tests, or chest X-rays. Chest X-rays use high-energy radiation to produce images of the chest area. They can check the shape and size of the heart and also can detect issues in valves or blood vessels near the heart.
How are Heart Palpitations Treated?
TreatmentHeart palpitations may not be related to a specific heart condition. If a doctor can rule this out, taking steps to avoid the triggers that cause palpitations might be recommended. These can include certain lifestyle changes and treatments such as:
- Reducing stress
- Avoiding stimulants
- Limiting alcohol
- Stopping the use of nicotine/tobacco products
- Regular exercise
- Maintaining healthy blood pressure and cholesterol
- Avoiding recreational drugs
- Avoiding certain foods that trigger your palpitations
Treatment for palpitations and arrhythmias is tailored to each patient and their medical needs. For some, reassurance and lifestyle changes are enough. For others, more active intervention is required:
- Vagal Maneuvers: Specific breathing techniques to slow a rapid heart rate.
- Medications: Beta-blockers, calcium channel blockers, or antiarrhythmic medications to slow or regulate the rhythm.
- Catheter Ablation: A minimally invasive procedure to eliminate the tiny area of heart tissue causing the "short circuit."
- Cardioversion: An electrical "reset" to restore a normal rhythm.
Managing Your Heart Health
Understanding what affects alcohol and caffeine can have on your heart rhythm and making lifestyle changes can help reduce heart palpitations. Here are ways to safeguard your heart health:
- Track your symptoms: Notice when palpitations occur and any associated symptoms.
- Talk with your cardiologist: Share your symptom log and discuss patterns related to caffeine or alcohol consumption. Your doctor can help determine safe limits, whether further testing is needed, and devise a treatment plan if you have arrhythmias or other heart conditions.
- Seek evaluation immediately if you experience: new or worsening palpitations, chest pain, shortness of breath, dizziness, or fainting.
- Don’t start. The medical opinion about even mild alcohol consumption has changed so that if you don’t drink alcohol, it is advised not to start, and if you do, to only have one or two drinks a day
Living With Palpitations: Coping and Follow-Up
Living With PalpitationsLiving with an irregular heartbeat requires working with your clinical team. We encourage patients to keep a "symptom diary" to note what they were doing and what they ate or drank before palpitations began. Managing stress through yoga or meditation and staying hydrated are helpful for long-term management.
When Palpitations Are Usually Not an Emergency
When Palpitations Are Usually Not an EmergencyIn most cases, heart palpitations are harmless.
You likely do not need emergency care if:
- The sensation lasts only a few seconds.
- They occur infrequently (e.g., once a month).
- They are triggered by a known factor, like a stressful event or a third cup of coffee, and resolve once the trigger is gone.
- You have no other symptoms like chest pain or dizziness.
When Palpitations Can Be a Sign of a Heart Problem
Sometimes, a flutter is more than just stress. Constant palpitations, especially if you have existing heart abnormalities, may be a sign of a more serious heart rhythm problem. Conditions like frequent PVCs (premature ventricular complexes), if left untreated, may weaken the heart muscle over time. SVT (supraventricular tachycardia) can cause significant discomfort. If your heart frequently "races" while you are at rest, you should get a formal evaluation. A persistent irregular heartbeat could signify atrial fibrillation, which can lead to stroke.
When to Call 911 Right Away
You should seek immediate emergency care if an irregular heartbeat occurs with these symptoms:
- Chest Pain: Pressure, squeezing, or pain in the center of the chest.
- Fainting or Near-Fainting: Sudden loss of consciousness or feeling like you will "black out."
- Severe Shortness of Breath: Difficulty catching your breath even while sitting.
- Sudden Confusion: Or a feeling of profound "doom" and weakness.
When to Call Your Doctor About Palpitations
To avoid future complications, it’s important to know when to see a doctor for palpitations. Schedule an appointment if:
- Frequency Increases: They are happening more often than they used to.
- Duration Grows: The episodes are lasting several minutes or longer.
- Medical History: You have a history of heart attack, valve disease, or heart failure.
- Concerns about AFib: If the rhythm feels completely chaotic and "un-rhythmical."
FAQs
This content has been reviewed by the following medical editors.
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