Palpitations
What is It?
Palpitations are the sensation of a pounding, fluttering, racing, or irregular heartbeat, or a feeling of missed beats. Episodes may last a few seconds, minutes, or longer. Palpitations are extremely common and in most cases are harmless and not a sign of serious heart disease. However, when associated with dizziness, loss of consciousness, chest pain or breathlessness, or when recurrent without a clear cause, early cardiology assessment is recommended.
What are the symptoms?
Palpitations may be felt in the chest, throat or neck, and are typically described as racing, fluttering, pounding, thumping, or skipping beats. They may occur at rest or with exertion, and are often more noticeable at night. Associated symptoms may include lightheadedness, shortness of breath, chest discomfort, or anxiety. Palpitations accompanied by fainting or severe chest pain require urgent assessment.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of palpitations. Causes and triggers include:
- Lifestyle triggers: Stress, anxiety, caffeine, alcohol, nicotine, recreational drugs, and strenuous exercise.
- Hormonal factors: Pregnancy, menstruation, menopause, and thyroid disease.
- Arrhythmias: Atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular ectopic beats, and more rarely ventricular tachycardia.
- Medical conditions: Anaemia, electrolyte imbalance, fever, dehydration, and certain medications.
How is it investigated?
A careful history and examination are important parts of assessment. Your One Heart Centre cardiologist will perform an ECG and in most cases an echocardiogram and ambulatory ECG monitoring (a heart monitor worn for 1 or more days) to capture and characterise the arrhythmia. Additional tests such as an exercise stress test, prolonged ambulatory monitoring, blood tests (including thyroid function and electrolytes), or electrophysiology study may be required.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing palpitations and will provide a personalised treatment plan for your palpitations. Treatment options include:
- Reassurance and trigger avoidance: For benign palpitations, simple reassurance and avoidance of triggers such as caffeine and alcohol may be all that is required.
- Medical therapy: Beta-blockers or calcium channel blockers may be used to control symptomatic palpitations.
- Treating the underlying cause: Managing thyroid disease, anaemia, or electrolyte imbalances.
- Catheter ablation: For specific arrhythmias such as SVT or frequent symptomatic ectopics.