Understanding palpitations: causes, diagnosis, and management

Written in association with: Dr Nickolaos Pantazopoulos
Published: | Updated: 29/11/2024
Edited by: Conor Lynch

Palpitations are the sensation of a rapid, irregular, or unusually strong heartbeat. While often harmless, they can sometimes indicate underlying medical conditions that require attention. Understanding the causes, diagnostic approaches, and management options is essential for addressing palpitations effectively.

What palpitations feel like

Palpitations may feel like a fluttering, pounding, or skipped beat in the chest, throat, or neck. They can be triggered by numerous factors, including stress, anxiety, excessive caffeine or alcohol consumption, dehydration, or certain medications.

 

Hormonal changes during pregnancy, menopause, or menstruation can also contribute. In some cases, palpitations may result from underlying heart conditions, such as arrhythmias (irregular heart rhythms), atrial fibrillation, or structural heart abnormalities. Other medical issues, such as hyperthyroidism or anaemia, might also play a role.

 

Worrying symptoms that accompany palpitations

When experiencing palpitations, it’s crucial to consider accompanying symptoms. While occasional palpitations without other signs are typically benign, symptoms like chest pain, shortness of breath, dizziness, or fainting could indicate a more serious issue requiring immediate medical evaluation.

 

Diagnosis and management

Diagnosing palpitations begins with a thorough medical history and physical examination. Your doctor may ask about lifestyle habits, triggers, and the duration and frequency of your symptoms.

 

Diagnostic tests often include an electrocardiogram (ECG) to assess heart rhythms, blood tests to detect underlying conditions like thyroid disorders, and imaging tests such as echocardiograms. For intermittent symptoms, a Holter monitor or event recorder may be recommended to track heart activity over a longer period.

 

Management of palpitations depends on the underlying cause. For benign triggers, lifestyle changes such as reducing caffeine or alcohol intake, managing stress through relaxation techniques, and staying hydrated can significantly reduce episodes. In cases related to arrhythmias or other heart conditions, treatment options may include medications, electrical cardioversion, or procedures like catheter ablation.

 

Palpitations are a common experience and often harmless, but they should not be ignored, especially if accompanied by concerning symptoms. Early evaluation and appropriate management can ensure peace of mind and optimal heart health. Always consult your healthcare provider if you’re unsure about your symptoms.

By Dr Nickolaos Pantazopoulos
Cardiology

Dr Nickolaos Pantazopoulos is a highly respected consultant cardiologist based in London. He specialises in chest pain, palpitations and hypertension and is also renowned for his expertise in breathlessness, echocardiogram and cardiac CT scanning.

After qualifying in medicine from the University of Queensland in 1994, Dr Pantazopoulos completed further training as a hospital intern in Brisbane, Australia. Following this, he was appointed as a doctor in the Greek Armed Forces and served within acute emergency air retrieval services operating in the islands of Greece. On completion of his specialist training in cardiology at the University of Athens, he pursued subspecialty training in cardiac CT at Johns Hopkins University in Baltimore, USA. He also gained further subspecialty experience in stress echocardiography and cardiac catheterisation at St George's Hospital, Sydney, Australia. In 2006, he was appointed as a consultant cardiologist at the Chelsea and Westminster Hospital and was awarded fellowship of the European Society of Cardiology in 2008. Dr Pantazopoulos is also an appointed fellow of the Royal College of Physicians of London. He sees private patients at several locations in London.

Dr Pantazopoulos has held a number of senior positions throughout his esteemed career and currently serves as clinical chair of the Syon Clinic and is cardiology clinical lead for BUPA Health Clinics. Additionally, he is a leading name in medical education and has been an honorary senior lecturer at Imperial College London since 2008. He also served as director of clinical studies at the Imperial College London School of Medicine for several years. Dr Pantazopoulos’ extensive academic publications appear in peer-reviewed journals. In 2013, he was awarded with a Level 3 Clinical Excellence Award by West Middlesex University Hospital in recognition of his world class patient care and practice.

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