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Irregular Heartbeat - Palpitations

Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of the cause of palpitations starts with a history and physical exam. Many times the palpitations have stopped by the time the person seeks medical attention. But the healthcare provider will want to know the answers to these questions:

Are the palpitations continuous or do they come and go?

What was the person doing when they noticed the palpitations?

Was the heart rate fast or slow?

Were there any other symptoms such as shortness of breath, chest pain, excessive sweating, or dizziness?

Does the person have any medical problems?

What medications or drugs is the person taking now?

Is there an increase in stress in the person's life?

Does the person drink a lot of coffee, tea, or soft drinks with caffeine or eat chocolate?

The healthcare provider may conduct any of these tests to check the palpitations:

ECG, electrical recording of the heart, to detect current palpitations

chest x-ray to evaluate the size and shape of the heart

echocardiogram for an excellent picture of any underlying disease of the heart that might be present. An echocardiogram is especially useful in detecting cardiomyopathy, valvular disease, atherosclerosis, and high blood pressure.

thyroid function tests to rule out underlying thyroid problems

Holter monitor, a portable device worn by a person to monitor the ECG for at least 24 hours. The Holter monitor is useful because many times the palpitations have stopped by the time the person seeks medical care.

Event recorders, a recording device activated by the person at the time of the palpitations to record the event

EPS, or electrophysiologic study, for serious arrhythmias. Done in a special laboratory, this test maps the electrical activity of the heart.

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