Palpitations are a common complaint—and often harmless. But certain patterns raise red flags for more serious rhythm problems, especially if symptoms are sustained, unexplained, or accompanied by danger signs.
When to Take Palpitations Seriously
The below features increase the likelihood of a significant arrhythmia:
- Episodes lasting minutes or longer
- Associated symptoms: chest pain, shortness of breath, dizziness, or fainting
- Known heart disease or family history of arrhythmia, syncope (fainting), or sudden cardiac death
- Resting heart rate over 100 bpm (outside of exercise, stress, or illness)
What to Track and Share with Your Doctor
Come prepared with:
- When it started, how long it lasts, how often it happens
- What it feels like (fluttering, pounding, skipping, racing)
- What brings it on (activity, lying down, caffeine, emotion)
- Any symptoms during or after (faint, weak, short of breath, chest tightness)
Tip: If possible, take your pulse or use a smartwatch to record heart rate during an episode. And be sure to keep a log or use a notes app to track episodes.
How Your Doctor May Evaluate Palpitations
Depending on your symptoms and risk factors, your doctor might order:
- Electrocardiogram (EKG): A quick test that shows a snapshot of your heart’s rhythm.
- Blood tests: To check for anemia, thyroid problems, or electrolyte imbalances that can trigger palpitations.
- Echocardiogram (Echo): An ultrasound to see evaluate the structure of your heart and how well it pumps.
- Ambulatory cardiac rhythm monitoring (event monitoring): Worn over time to catch irregular heartbeats that come and go. This can include a 24–48 hour Holter monitor, a 2–4 week continuous loop recorder, or an implantable loop recorder placed under the skin that tracks your heart for years.
So while many palpitations are benign—not all are. A clear symptom story and the right questions help ensure your concern is taken seriously and evaluated safely.
Questions You May Want to Discuss With Your Doctor
- What possible heart rhythm problems could be causing my palpitations?
- Should I get an EKG to check for findings that might suggest increased risk for arrhythmias?
- Are there any blood tests I should have to look for causes of palpitations like thyroid or electrolyte issues?
- Should I get an echo to look for any structural heart problems?
- Could any of my medications be causing my palpitations?
- Even though I’m at low risk for an arrhythmia, I’m still concerned – can we arrange for an event monitor?
- How do you decide how long I should wear a heart monitor?