Heart palpitations

To diagnose palpitations, a health care provider will do a physical exam and listen to your heart using a stethoscope. The exam may include looking for signs of medical conditions that can cause heart palpitations, such as a swollen thyroid gland. You will likely be asked questions about your medical history.

If your doctor thinks that palpitations are caused by an irregular heartbeat or other heart condition, tests might include:

• Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An electrocardiogram (ECG) can show if the heart is beating too slow, too fast or not at all.
• Holter monitoring. This portable ECG device is worn for a day or more to record the heart's rate and rhythm during daily activities. It's used to detect heart palpitations that aren't found during a regular ECG exam. Some personal devices, such as smartwatches, offer remote ECG monitoring. Ask your health care provider if this is an option for you.
• Event recording. If you don't have irregular heart rhythms while you wear a Holter monitor or if the events occur less than once weekly, your health care provider might recommend an event recorder. You press a button when symptoms occur. An event recorder is typically worn for up to 30 days or until you have an arrhythmia or symptoms.
• Echocardiogram. This noninvasive exam uses sound waves to create moving pictures of the heart in motion. It can show blood flow and structure problems with the heart.

Unless the palpitations are caused by a heart condition, heart palpitations rarely require treatment. Instead, a health care provider might recommend taking steps to avoid the triggers that cause palpitations.

If palpitations are caused by a heart condition, such as an irregular heartbeat (arrhythmia), treatment will focus on correcting the condition.

The most appropriate way to treat palpitations at home is to avoid the triggers that cause the symptoms.

• Reduce stress. Try relaxation techniques, such as meditation, yoga or deep breathing.
• Avoid stimulants. Caffeine, nicotine, some cold medicines and energy drinks can make the heart beat too fast or irregularly.
• Avoid illegal drugs. Certain drugs, such as cocaine and amphetamines, can cause heart palpitations.

If you have heart palpitations with severe shortness of breath, chest pain or fainting, seek emergency medical attention.

If your palpitations are brief and there are no other worrisome signs or symptoms, make an appointment to see your health care provider. A health care provider can help determine if palpitations are harmless or a symptom of a more serious heart condition. You may be referred to a doctor who specializes in heart diseases (cardiologist).

Here's some information to help you get ready for your appointment:

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of:

• Your symptoms, including any that seem unrelated to heart palpitations, and when they began
• Key personal information, including family history of heart disease, arrhythmias, stroke, high blood pressure or diabetes, as well as major stresses or recent changes in your life
• All medications, vitamins and supplements you take, including doses
• Questions to ask your health care provider

Take a family member or friend along, if possible, to help you remember the information you're given.

For heart palpitations, basic questions to ask your health care provider 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?
• I have other health conditions. How can I best manage them together?
• Are there restrictions I need to follow?
• Should I see a specialist?
• 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 health care provider is likely to ask you questions, such as:

• Do you always have palpitations or do they come and go?
• Do the palpitations start and stop suddenly?
• Do the palpitations seem to occur at the same time every day or during a certain activity?
• What, if anything, seems to improve symptoms?
• What, if anything, appears to worsen symptoms?
• Are you having other symptoms such as shortness of breath, chest pain, fainting or dizziness when you have palpitations?
• Do you have a history of heart rhythm problems, such as atrial fibrillation?

What you can do in the meantime

Before your appointment, you can try to improve your symptoms by avoiding stress or activities that might cause palpitations. Some common triggers include:

• Anxiety or panic attacks
• Too much caffeine or alcohol
• Use of medications or supplements that contain stimulants, such as energy drinks or some cold medicines