Diagnosis

If your doctor thinks you have heart palpitations, he or she will listen to your heart using a stethoscope. Your doctor may also look for signs of medical conditions that can cause heart palpitations, such as a swollen thyroid gland.

Other tests your doctor may perform include:

  • Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat.

  • An ECG can help your doctor detect irregularities in your heart's rhythm and structure that could cause palpitations. The test may be performed while you rest or exercise (stress electrocardiogram).

  • Holter monitoring. A Holter monitor is a portable device that you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart palpitations that aren't found during a regular ECG exam.
  • Event recording. If you don't have irregular heart rhythms while you wear a Holter monitor, your doctor may recommend an event recorder.

    You wear an event recorder as much as possible throughout the day, and push a button on a recording device you wear on your belt to record your heartbeat when you have symptoms. You may need to wear an event monitor for several weeks.

  • Echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function.

    Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.

Treatment

Unless your doctor finds that you have a heart condition, heart palpitations seldom require treatment. Instead, your doctor may recommend ways for you to avoid the triggers that cause your palpitations.

If your palpitations are caused by a condition, such as an arrhythmia, your treatment will focus on correcting the condition.

Lifestyle and home remedies

The most appropriate way to treat palpitations at home is to avoid the triggers that may cause your symptoms. Some ways to avoid triggers include:

  • Reduce stress or anxiety. Try relaxation techniques, such as meditation, yoga, or deep breathing or aromatherapy.
  • Avoid stimulants. Stimulants, including caffeine, nicotine, some cold medicines and energy drinks, can make your heart beat quickly or irregularly.
  • Avoid illegal drugs. Certain drugs, such as cocaine and amphetamines, can bring on heart palpitations.

Preparing for your appointment

If you have heart palpitations with severe shortness of breath, chest pain or fainting, you should seek emergency medical attention. If your palpitations are brief and there are no other worrisome signs or symptoms, make an appointment to see your doctor. Your doctor can help you find out if your palpitations are harmless or a symptom of a more serious heart condition.

If you make an appointment with your doctor, it's good to prepare. Here's some information to help you get ready for your appointment:

What you can do

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet or fast.
  • Write down any symptoms you're experiencing, including any that seem unrelated to heart palpitations.
  • Write down key personal information, including family history of heart disease, arrhythmias, stroke, high blood pressure or diabetes. Also include major stresses or recent changes in your life.
  • Make a list of medications, vitamins and supplements you're taking.
  • Take a family member or friend along, if possible. Someone who accompanies you may remember something you miss or forget.
  • Be prepared to discuss your diet and exercise habits, including challenges you might face in improving your diet or moving more.
  • Write down questions to ask your doctor.

To make the most of your time with your doctor, write down questions to ask. For heart palpitations, some basic questions include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • What should I do if my symptoms return?
  • What tests will I need?
  • Do I need treatment and, if so, what?
  • What are the alternatives to the primary approach you're suggesting?
  • What's an appropriate level of physical activity?
  • I have other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Should I see a specialist?
  • Is there a generic alternative to the medicine you're prescribing?
  • Do you have brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • When did you begin having heart palpitations?
  • Have your symptoms been continuous or occasional?
  • Do your palpitations start and stop suddenly?
  • Does it seem like your palpitations have a pattern, such as occurring the same time every day or when you do a certain activity?
  • Does your heart still beat regularly during the palpitations?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Are you having other symptoms such as shortness of breath, chest pain, fainting, or dizziness when you have palpitations?
  • Have you ever had heart rhythm problems before, such as atrial fibrillation?

What you can do in the meantime

Before your appointment, you can try to improve your symptoms by avoiding activities or stresses that might cause your palpitations. Some common triggers include anxiety or panic attacks, drinking too much caffeine or alcohol, or taking some medications or supplements that contain stimulants, such as energy drinks or some cold medicines.

April 02, 2014
References
  1. Zimetbaum PJ. Overview of palpitations in adults. http://www.uptodate.com/home. Accessed Nov. 26, 2013.
  2. Palpitations. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hpl/hpl_all.html. Accessed Nov. 26, 2013.
  3. Wexler RK, et al. Outpatient approach to palpitations. American Family Physician. 2011;84:63.