What is palpitation?
Normally our heart is beating regularly at a rate between 60-100 per minute. But we are not aware of it. In certain circumstances, we become aware of our own heart beat. This is known as palpitation. Very often palpitation is just a manifestation of anxiety. When you are stressed or with exercise, the heart races and we become aware of our heart beating fast. Though most often palpitation is harmless, in some situations it could be a manifestation of a dangerous disease. For example, abnormal heart rhythms can cause palpitation. Very fast rhythms can be regular or irregular. Sometimes it may not be continuous palpitation, but feeling of an occasional flutter in the chest. This is due to transient irregularity in the heart rhythm, which is often of not much significance.
Serious forms of palpitation occurs in those with severe heart disease – either electrical or structural. Structural abnormalities of the heart which damage the heart muscle or heart valves can cause paliptation due to extra load which it gives the heart. Electrical disorders of the heart often produce either very fast rhythms or very slow rhythms, both of which can be life threatening if severe.
One of the simple tests to analyse the heart rhythm in case of palpitation is an ECG. Structural damage to the heart can be assessed by ultrasound imaging of the heart known as echocardiography. Both these tests are commonly done for evaluation of heart disease. Other more advanced tests are needed only in selected cases. If the palpitation is only occasional, it can be recorded by long term ECG monitoring known as Holter monitoring (typically 24-48 hours) or event monitoring (one week to three months). If still longer recording is needed, we have implantable loop recorders – small devices which can be implanted under the skin under local anaesthesia, which can record electrical abnormalities of the heart for up to 3 years. These devices have wireless options which can relay the signals to a device at home which in turn can transmit it to a central server by mobile networks. The central server could be even located in another continent!