Question 1

What is palpitations?

Accepted Answer

Palpitations describe the subjective experience of being aware of the heartbeat in an unpleasant, noticeable, or alarming way. They may be perceived as rapid (tachycardia), irregular (ectopic beats, atrial fibrillation), forceful (high-output states), or skipping (premature ventricular or atrial contractions). The vast majority of palpitations presenting in primary care are benign — most commonly ectopic beats, sinus tachycardia driven by anxiety or caffeine, or normal exertional heart rate increase.

Question 2

What do people commonly experience with palpitations?

Accepted Answer

People describe their heart pounding in their chest, a fluttering sensation, a racing heartbeat at rest, or a feeling that the heart has 'skipped' followed by a strong beat.

Question 3

What lifestyle changes can help with palpitations?

Accepted Answer

Reducing caffeine and alcohol is often the most impactful immediate intervention. Identifying emotional or situational triggers (stress, anxiety, exertion, posture) informs management. Slow diaphragmatic breathing activates the vagus nerve and may reduce palpitation frequency. Magnesium-rich diet or supplementation is worth considering in the context of diet assessment. Regular, moderate exercise is cardioprotective but should be guided by cardiac assessment if palpitations occur during exertion.

Question 4

What integrative approaches support palpitations?

Accepted Answer

Investigation of palpitations includes 12-lead ECG, 24-hour or longer Holter monitoring (or event recorder for infrequent symptoms), thyroid function, electrolytes, and full blood count. Benign ectopic beats typically require reassurance and lifestyle modification only. Atrial fibrillation is managed with rate or rhythm control and anticoagulation. SVT may be terminated with vagal manoeuvres or adenosine and managed with beta-blockers or ablation. Anxiety-related palpitations respond to anxiety treatment.

Question 5

When should I seek professional support for palpitations?

Accepted Answer

Seek urgent medical assessment for palpitations with chest pain, breathlessness, presyncope, syncope, or known structural heart disease. Same-day ECG is appropriate for first-presentation palpitations. Seek routine assessment for palpitations without associated features — Holter monitoring may be requested.

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