Heart Palpitations: What to Expect at Your Appointment

Many people have experienced a heart palpitation at least once - that odd fluttering in your chest, feeling like your heart is beating too hard, or thinking your heart skipped a beat.  Palpitations, or occasional irregular heartbeats, are fairly common and can be triggered by many things - stress, alcohol, caffeine, medications and supplements, or even hormonal changes. In many cases, they occur infrequently and don’t require medical attention. At times, though, heart palpitations may be a symptom of something more serious that needs medical attention. 
If heart palpitations are paired with chest pain or tightness, dizzy spells, fainting spells or shortness of breath, you should seek immediate medical attention. If your palpitations are not paired with these symptoms but are still worrisome to you, schedule an appointment with your primary care physician or a specialist at the Heart Rhythm Institute at Oklahoma Heart Hospital for further evaluation. 
There are several ways you can prepare for your appointment and potentially reduce the frequency or severity of your palpitations. First, keep a written record of when your palpitations occur, what might be causing them, and what helps relieve them. Do they happen after exercise? During a specific time of a woman’s monthly cycle? A few hours or few days after starting a weight loss supplement? More frequently during periods of increased stress? Do you notice the palpitations more after drinking caffeine or using nicotine? If your palpitations occur when you are sitting, does getting up and moving make them stop? If you reduce your caffeine intake, do you notice fewer palpitations? 
At your visit, your doctor will take your personal and family medical history, ask you about medications and supplements you take, and ask you about key lifestyle factors.  Your doctor will also talk to you about frequency, duration, and triggers for your palpitations, which is where a written record of symptoms will be helpful. 
After discussing the symptoms and possible triggers for your palpitations, your doctor will likely run some tests to examine how your heart is functioning. The first test may be an electrocardiogram, also known as an ECG or EKG. This test graphs the electrical activity of your heart and can be useful in identifying irregular rhythms. Some doctors also may use an ultrasound to examine the heart structure. 
For patients with infrequent palpitations, an in-office EKG may not provide enough information, especially if no palpitations occur during the EKG. In some cases, patients may be sent home with a wearable heart monitor to record the heart for anywhere from 24 hours to one week. This additional data may help identify what’s happening in the heart during palpitations and whether it requires additional testing or treatment. 
As with any medical issue, talk to your doctor openly about your symptoms, your concerns, your lifestyle, and your family history. These details in combination with any tests done on your heart will help identify the cause and potential treatment options, if treatment is needed.