What is the diagnosis of Heart Palpitations?

By  ,  National Institute of Health
Jan 06, 2013

Your doctor will first want to find out whether your palpitations are harmless or related to a more serious heart problem. To do this, he or she will ask about your symptoms and medical history, do a physical exam, and recommend several basic tests.

This information may point to a heart problem as the cause of your palpitations. If so, your doctor may recommend more tests. These will help show what the problem is and how to treat it.

The cause of palpitations may be hard to diagnose, especially if symptoms don't occur regularly.

Specialists Involved

Several types of doctors may work with you to diagnose and treat your palpitations. These include a:

  • Primary care doctor
  • Cardiologist (a doctor who specializes in diagnosing and treating heart diseases and conditions)
  • Electrophysiologist (a cardiologist who specializes in the heart's electrical system)

Medical History

Your doctor will ask questions about your palpitations, such as:

  • When did they begin?
  • How long do they last?
  • How often do they occur?
  • Do they start and stop suddenly?
  • Does your heartbeat feel steady or irregular during the palpitations?
  • What other symptoms do you have when you get palpitations?
  • Do your palpitations have a pattern? For example, do they occur when you exercise or drink coffee? Do they happen at a certain time of day?

Your doctor also will ask you about your use of caffeine, alcohol, supplements, and illegal drugs.


Physical Exam

Your doctor will take your pulse to find out how fast your heart is beating and whether it's beating with a normal rhythm. He or she also will use a stethoscope to listen to your heartbeat.

Your doctor may look for signs of other conditions (such as an overactive thyroid) that can cause palpitations.

Diagnostic Tests

Often, the first test that's done is an EKG (electrocardiogram). This simple test records your heart's electrical activity.

An EKG is used to detect and locate the source of heart problems. It shows how fast your heart is beating and whether its rhythm is steady or irregular. It records the strength and timing of electrical signals as they pass through each part of your heart.

Even if your EKG results are normal, you may still have a medical condition that's causing palpitations. If your doctor suspects this is the case, you may have blood tests to gather more information about your heart's structure, function, and electrical system.

Holter or Event Monitor

A standard EKG only records the heartbeat for a few seconds. It won't detect heart rhythm problems that don't happen during the test. To diagnose problems that come and go, your doctor may have you wear a Holter or event monitor.

A Holter monitor records the electrical activity of your heart for a full 24- or 48-hour period. You wear small patches called electrodes on your chest. Wires connect the patches to a small, portable recorder. The recorder can be clipped to a belt, kept in a pocket, or hung around your neck.

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