Usually people do not notice their heart beating. Palpitations are heartbeats you notice, as they are unusually fast, strong or irregular. As a consequence, you feel an irregular pulse. Palpitation can be completely harmless, but may indicate heart disorders such as arrhythmias. Alcohol, caffeine, drugs and medication can also cause palpitations.
Palpitations can have various causes, therefore, patients need a careful examination. If you have normal blood pressure, no health problems or pre-existing heart diseases, and palpitations occur at rest, they are not caused by a medical condition. In this case, you do not need medical treatment, as symptoms will disappear on their own. If palpitations occur more frequently, or you have the above-mentioned conditions, you will need a heart exam.
An electrocardiogram (ECG) records the heart’s electrical activity at rest and during exercise. This provides the physician with useful information about the heart and possible disease. A cardiac ultrasound (echocardiography) can also indicate possible diseases. A long-term ECG is useful to detect when and during what activities palpitations occur. Holter devices monitor the electrocardiogram over a 24-hour period. Event recorders are only activated by patients when they feel a palpitation. If a palpitation’s cause cannot be detected and it only occurs rarely and with serious symptoms like syncope, heart activity should be monitored over a very long period.
Palpitations that are not caused by a medical condition can be prevented or reduced in duration. If, for example, caffeine is the cause, you should refrain from consuming it. If palpitations occur during physical exertion, physician-directed training can help gradually reduce them. Medication, relaxation therapy or psychotherapy can help with psychosomatic palpitations.
In the case of palpitations caused by the heart, for example arrhythmia, the same advice to prevent or improve the disease can also improve palpitations.