Palpitations are are often harmless, but in some cases, may even be due to a life-threatening condition. A detailed description of the symptoms by the patient can provide clues to the diagnosis of the cause of palpitations.
An abnormality in rate and/or rhythm of heart beat is referred to as arrhythmia. Arrhythmias can often lead to palpitations.
Though the heart beats on its own, the rate and rhythm can be affected by inputs from nerves, chemical substances like adrenaline in the blood, and electrolyte and hormonal abnormalities.
Some of the sensations that a person feels during a palpitation are:
(1) Flip-flopping or ‘start and stop’ palpitations – These palpitations are a consequence of premature or early contractions of the atria and ventricles
(2) Fluttering of the chest – A regular fluttering in the chest suggests supraventricular or ventricular arrhythmia (an arrhythmia arising in the ventricle or just above the ventricle), whereas an irregular fluttering of the chest may indicate atrial flutter or fibrillation (abnormally fast and irregular contractions of the atria).
(3) Pounding in the neck – This type of palpitation is observed when the right atrium contracts against a closed heart valve. The cause of palpitation may be diagnosed based on the type of palpitation and associated symptoms. Some of the associated symptoms that may help to clinch the diagnosis are:
(4) Palpitations associated with chest pain may be due to angina or heart attack.
(5) Palpitations with chest pain that is relieved when the patient moves forward may be due to pericardial disease (the pericardium is the tissue covering the heart).
(6) Palpitations associated with weight loss may be due to hyperthyroidism
Palpitations following excessive vomiting or diarrhea may be due to dehydration and electrolyte abnormalities
(7) Palpitations due to anxiety or panic disorder are associated with hyperventilation, hand tingling and nervousness.