Palpitations are symptoms described by people when they are aware of their heart beating. Usually the sensation is most prominent in their chest but some people will also be aware of the feeling in their throat as well.

Most people are aware of their heart beat at times and indeed it is is normal to be able do so particularly after heavy exertion when the heart has had to work hard to respond to the extra demands of the body during sudden or sustained physical activity. Other occassions when we are all likely to be aware of our heart beat is when we are at rest but feeling anxious, frightened or angry. This is because the body responds to these stimuli by releasing more adrenaline into the blood stream which in turn stimulates the heart to beat harder and faster.

Whilst palpitations are one of the commonest reasons for a person to consult a cardiologist, most palpitations are not potentially harmful to the patient but merely irritating. Some palpitations however can be dangerous in themselves and some may indicate underlying heart disease that merits further investigation and treatment in its own right. Even if the palpitations are merely an irritation it may be worthwhile trying treatments in some cases to provide relief from the symptoms.

Clearly as with all medical issues the first thing to decide in the patient experiencing palpitations is a firm diagnosis. This is best achieved by obtaining a heart tracing (electrocardiogram; ECG) at the time the patient is experiencing their symptoms. This isn't always easy, but understanding the frequency of the attacks and their duration can be very helpful in determining which method is most likely to suceed. Sometimes keeping a diary of the symptoms may help the doctor in deciding which test to try first. The various monitoring methods are described in Tests and Investigations.

It is worthwhile if you are going to see your doctor about palpitations trying to think what the palpitations feel like to you. In this way you will be able to describe them accurately to him which is important as different sensations may suggest different specific diagnoses. Things worth trying to note in particular are:

All these are important points that may help the doctor decide what type of heart rhythm disturbance might be happening.

The links below will take you to descriptions and explanations of the commonest types of palpitations. The first section describes the normal heart beat and rhythm and is worth looking at first as it may make understanding the nature of the abnormal rhythms easier. Each section has an animated diagram which I hope will help in the understanding of the way the electrical impulses travel through the heart to generate the heart beat and how the different palpitations (arrhythmias) occur.

For patients who wish to find out more about palpitations and rhythm disturbances or explore joining a patient support group then a starting place might be the Arrhythmia Alliance web site. Arrhythmia Alliance