Palpitations: what to do?

Are you having palpitations? For starters: you are not alone. Palpitations are very widespread. They are one of the main reasons why patients go to see their GP, cardiologist or end up at Accident & Emergency.¹ But these medical checks and even further examinations do not always result in a clear diagnosis.² Why is that? And what can you do yourself to find out whether your palpitations are harmless or not? 

What are palpitations?

Let us start at the beginning. How to know if your palpitations are cause for concern? Medical literature defines palpitations as ‘the sensation of an unusually fast or irregular heartbeat, often described as an uncomfortable pounding feeling in one’s chest or neck’.²

This uncomfortable feeling can be an (abnormally) fast heart rate, irregular heart rhythm, the heart skipping beats, fluttering  or a very pulsating sensation.

Doctor Gupta, a renowned cardiologist based in York, England, describes it simply as follows: ‘If you are conscious of your heartbeat  in the sense that it feels out of the ordinary, you’ve got palpitations. It does not even need to be a medical abnormality. Your heart can be working perfectly normally, even though you feel things are abnormal.’ ³

Which is exactly where the problem lies. When we are in a normal condition of rest, none of us are even aware of our cardiac activity.¹ So when we do feel palpitations at that moment, it is important to identify the cause. Because palpitations are a symptom. But a symptom of what?

Are palpitations (ab)normal?

Palpitations and heart rhythm disorder: a clear link

We have established that palpitations can have different causes. Elements such as stress or depression for instance are often singled out as the culprits. But even in three quarters of psychologically triggered palpitations (worrying, anxiety, depression, etc.) there is an underlying heart rhythm disorder lurking in the background.⁴

Research shows that in the bulk of cases (a conclusive 81 %), heart rhythm disorders are the cause.²

Atrial fibrillation is the most common form of heart rhythm disorder and just happens to be one culprit you can catch in the act whilst lounging around in your comfy chair.

How do you pinpoint the cause of your palpitations?

Are these palpitations harmless or a cause for concern? A question which undoubtedly is frequently on your mind, but also one that often proves frustrating for doctors. Especially as the problem with palpitations is their temporary nature. You can feel them on a daily or weekly basis, or sometimes just once every month or so. Sometimes for hours on end, sometimes for just a few seconds.

This unpredictability means catching them when they are occurring is terribly difficult. There is a good chance that you will not have any symptoms when you are being examined.¹ Whereas there is scientific evidence that recording your cardiac activity during symptoms offers the best chances of the right diagnosis.¹ In 76% of cases, this immediately tells doctors what needs to be done.²

Without palpitations occurring during your examination, the real causes can go undetected – sometimes even for years.² Without a clear cause there is no treatment.

The upshot? You are left feeling uncomfortable and concerned. Wondering if what you are feeling are actually palpitations. And is what you are feeling harmless or not? How do you stop yourself from lying awake at night worrying next time you experience these symptoms?

What to do in case of palpitations?

The medically certified FibriCheck app gives you a reliable tool which you can use in the comfort of your own home. Are you having palpitations? Measure your heart rhythm right there and then, using your smartphone and/or smartwatch (Fitbit and Samsung Galaxy Watch3).

This will tell you in less than a minute whether your heart rhythm is safe at that moment. Quite a relief. What if the app does detect abnormal cardiac activity? Within 48 hours you get a personal review (*) of the measurement results by our medical experts.

In the meantime, keep measuring. This sees you collect vital medical evidence which immediately gives your doctor a detailed insight into your heart rhythm. Do the measurements point to heart rhythm disorders such as atrial fibrillation or auricular fibrillation? Or should your doctor seek to find a structural cardiac problem? In this situation too, it is a case of managing by measuring.

Please note! If you are feeling palpitations and you are simultaneously suffering from symptoms such as shortness of breath, faintness or pain in your chest, get in touch with your GP as soon as possible. Especially when there is a family history of heart conditions.

(*) Personal reviews by our medical experts are included in our free trial period and Premium plan.  

References

1. Giada F et al. Clinical Approach to Patients with Palpitations. Card Electrophysiol Clin, 2018, doi:10(2):387-396.
2. Clementy N et al. Benefits of an early management of palpitations. Medicine (Baltimore), 2018, doi:97(28):e11466.
3. Dr. Sanjay Gupta. York Cardiology. Geraadpleegd op https://www.youtube.com/watch?v=-7rDc5f8muk
4. Goyal A et al. Palpitations. StatPearls [Internet], 2020.