What is palpitation?
Strictly speaking, a palpitation is a symptom rather than a condition. It’s a feeling or awareness of changes in the beats or rhythm in your heart. Some people feel as though their heart is beating faster or more slowly, or more forcefully than normal. Others experience a fluttering or buzzing sensation, or a feeling that their heart is skipping or adding a beat. They can happen intermittently, or for a more sustained period. These feelings aren’t necessarily restricted to the chest; some people experience palpitation in their neck or throat as well. Palpitation can happen during rest or when you’re active or exercising. In some cases, they can be accompanied by dizziness, breathlessness or chest pain and discomfort; if this happens, you should see a doctor immediately.
Who tends to get palpitation?
Palpitation can affect people of all ages, from children and teenagers to older people. Hormonal changes can sometimes also trigger them during menstruation, pregnancy or around the menopause.
What causes palpitation?
There are many different reasons why you might experience heart palpitation, and it can be difficult to identify the exact cause. Sometimes they’re triggered by particular activities, such as strenuous exercise. Sometimes people find that certain kinds of food or drink – alcohol, energy drinks, caffeinated drinks like tea and coffee, and even rich, carbohydrate-heavy food – can bring on the symptoms. Illegal drugs and nicotine can raise the risk of developing palpitations too, as can certain kinds of medicines, such as decongestants, blood pressure medication, or treatments for arrhythmia.
A number of non-heart-related medical issues can also trigger palpitations. These include physical conditions like anaemia and thyroid disease, but also psychological issues such as stress, anxiety disorders, panic attacks and even sleeplessness. Although most palpitations are harmless, in certain cases they can be a symptom of a more serious heart rhythm disorder. For this reason, it’s a good idea to have them investigated if they worsen or become more persistent, or if they are accompanied by pain, breathlessness or loss of consciousness, or if you have a history of heart problems.
How would you diagnose them?
Since a palpitation is essentially a symptom you experience, our main task is to find out what might be behind that symptom. When you come into clinic, we’ll start by asking about your medical history, any medicines you might be taking and exactly what the palpitation feels like. We’ll also ask you when they happen, and whether anything tends to set them off. Do they come and go, or are they very frequent? What kind of diet or lifestyle activities might be prompting them? We will also want to know if you’re experiencing any other symptoms with the palpitations; discomfort or pain in the chest, fainting, dizziness and breathlessness could indicate a more serious heart problem that may need urgent investigation. We might also take a closer look at your heart rate and heart rhythm. Some potential tools for diagnosis include an electrocardiogram (ECG), holter monitoring and electrophysiology studies (EPS).
What happens next?
Most palpitations are harmless, and they will often disappear by themselves over time. Many won’t need any treatment at all. Sometimes, though, it might be necessary to consider some changes to your diet or lifestyle. This might involve reducing stress with relaxation techniques and exercises, or perhaps starting a weight loss plan, or avoiding certain substances such as alcohol, caffeine and smoking. If your regular prescription seems to be causing the symptoms, we may also recommend a change of medication.