Heart Palpitations – Diagnosis and Treatment
People sometimes notice odd feelings in their chest, like the heart fluttering or seeming to skip a beat. These sensations, known as palpitations, can happen for many reasons and often make people wonder if something is wrong with their heart.
Diagnosis
Doctors use a step-by-step approach to figure out the cause of symptoms like chest pain, fluttering sensations, skipped heartbeats, dizziness, or fainting. They begin with a physical exam and listen to your heart with a stethoscope.
Sometimes, they also check for an enlarged thyroid, which can affect heart rhythm.
Your health history is important. Doctors ask about symptoms such as shortness of breath, sweating, fatigue, or recent stress. If needed, they order tests to evaluate your heart’s rhythm and structure or rule out other causes.
Common diagnostic tools include:
- Electrocardiogram (ECG or EKG): A fast, non-invasive test that records the heart’s electrical signals using electrodes on the skin. It detects arrhythmias such as atrial fibrillation, flutter, or ventricular tachycardia.
- Holter Monitor: A portable device worn for 24 hours or longer to record continuous heart activity during normal daily activities. It identifies irregular heart rhythms that a short ECG might miss.
- Event Recorder: Worn over several weeks, this tool is activated by the patient when symptoms occur. It’s ideal for detecting infrequent episodes of paroxysmal supraventricular tachycardia (PSVT) or palpitations.
- Echocardiogram: Uses ultrasound waves to create moving images of the heart. It evaluates heart valves, structure, function, and can reveal conditions like congenital heart disease or heart failure.
- Chest X-ray: Helps assess the size and shape of the heart and nearby organs to detect issues like heart enlargement or fluid buildup.
- Stress Test: Assesses how the heart functions during physical exertion. It can identify signs of myocardial ischemia or other heart conditions.
- Blood Tests: Used to check for thyroid imbalances, electrolyte abnormalities, or markers of heart damage that could contribute to symptoms.
Additional testing may be needed for people with a family history of heart conditions, congenital heart defects, or recurrent fainting spells. Wearable technology like smartwatches with ECG capability can also help track heart rhythm over time.
These tools not only diagnose the root cause of palpitations or arrhythmias but also guide the best course of treatment—whether it’s medication, lifestyle changes, or a specialized procedure like cardiac ablation.
Treatment
Treatment depends on what causes the palpitations. If doctors find a heart problem like arrhythmia, coronary artery disease, or complications such as a heart attack or stroke, they may recommend medicines like antiarrhythmics.
In some cases, doctors treat conditions like hyperthyroidism or other thyroid disorders. For mild cases, avoiding triggers and lowering stress often help.
Quick Reference Table:
| Cause | Possible Treatment |
|---|---|
| Arrhythmia | Antiarrhythmics, procedures |
| Thyroid Disorders | Medication or hormone therapy |
| Coronary Artery Disease | Lifestyle changes, medications |
| Risk of Stroke or Heart Attack | Monitoring, tailored care |
Taking Care at Home
Many people manage heart palpitations by making simple changes to daily habits. It’s important to cut down on stimulants like caffeine, tobacco, and energy drinks.
Avoiding alcohol and certain herbal supplements can also help. Practicing relaxation, such as deep breathing or meditation, may lower stress.
Keeping a healthy weight, controlling high blood pressure and diabetes, and treating sleep apnea support heart health.
Getting Ready for Your Visit
Steps You Can Take Beforehand
To prepare for your doctor’s appointment, get organized. Call the office to check if there are any special instructions, such as not eating or avoiding certain medicines.
Write down:
- All symptoms you have, including when they started and any patterns—even if the symptoms seem unrelated to heart palpitations.
- Personal and family health information, like a history of heart problems, high blood pressure, diabetes, or recent stressors.
- A current list of medications (including all prescription drugs, vitamins, and supplements, along with their doses).
- Questions you want to ask, so you don’t forget during your visit.
Consider bringing a family member or a friend. They can help you remember what the doctor says and provide support.
Some helpful questions you might ask:
| Topic | Sample Questions |
|---|---|
| Symptoms and Diagnosis | What could be causing my symptoms? What tests are needed? |
| Treatment | Will I need treatment? What does it involve? |
| Lifestyle and Restrictions | Are there any activities I should avoid? |
| Follow-up | What should I do if my symptoms come back? |
| Specialist Referral | Should I see a cardiologist? |
Ask anything else that concerns you during the visit.
Common Questions From Your Health Care Provider
Your health care provider will likely ask specific questions to better understand your situation. Being ready for these questions can make your visit more productive.
Here are some topics you might be asked about:
Whether palpitations are constant or come and go.
If there’s a pattern to when palpitations start and stop.
Any activities or situations that seem to bring on or worsen your symptoms.
Actions or factors that make your symptoms better.
Other symptoms, such as shortness of breath, chest discomfort, fainting, or dizziness.
Personal or family history of heart rhythm issues.
Clear answers help your provider decide if you should see a cardiologist or get more tests.
Actions You Can Take While Waiting
While you wait for your appointment, you can take steps that may lessen your symptoms or help prevent palpitations from returning.
Avoid the following:
Stress and anxiety triggers.
Caffeine or alcohol, as both can affect heart rhythm.
Over-the-counter products, like some cold remedies and energy drinks, may have ingredients that stimulate your heart.
Practice deep breathing exercises or choose calming activities. If your symptoms become severe or you experience chest pain, fainting, or extreme shortness of breath, seek emergency care right away.
