I have been experiencing palpitations for a few months now and this is often accompanied by shortness of breath and dizziness. I have been working long hours recently. Do you think that there could be something seriously wrong with me?
I have made an appointment to see my GP. Do you think I might need to see a specialist?
Dr Lee Graham, Consultant Cardiologist and Electrophysiologist:
Palpitations are a common symptom and refer to an awareness of your own heart beating. Patients may feel their heart beating at a normal rate, a faster rate which may be regular or irregular, or feel their heart skipping or missing beats. Palpitations often cause a sensation of fluttering or pounding in the chest and are usually intermittent.
Many people will experience palpitation at some stage in their lives but most do not have a serious underlying heart condition. However, the sensation is often unpleasant and can cause considerable worry or distress. If your symptoms persist or are associated with symptoms such as breathlessness or dizziness then you should initially consult with your GP who may arrange for you to have an electrocardiogram (ECG). This records the electrical activity of the heart and whilst it is often normal in patients with palpitation, can sometimes pick up an abnormal heart rhythm or “arrhythmia”.
You may also be referred to a cardiologist, often one who specialises in abnormal heart rhythms (Cardiac Electrophysiologist) for further assessment and tests to identify if there is a problem. These may include a 24-hour ECG recording if your palpitations occur frequently or an exercise ECG if your palpitations are triggered by exertion. Other tests such as a cardiac ultrasound (echocardiogram) can sometimes be helpful in identifying patients with underlying structural heart disease.
Depending on the cause, palpitations may not require specific treatment although sometimes medication is tried initially. Sometimes a slightly more invasive test called an electrophysiological (EP) study can be performed to identify extra electrical connections in the heart which may cause fast abnormal heart rhythms called supraventricular tachycardia (SVT). If these can be identified then catheter ablation can be performed at the same time. This is often very successful and can offer a cure for many patients.