palpitations CT scan preparation

Overview

Palpitations are feelings of a fast, fluttering, or pounding heartbeat. They can happen when you’re active or at rest. A CT scan (computerised tomography scan) uses X-rays to take detailed pictures of your heart to help find the cause of palpitations.

Yes, most people experience palpitations at some point in their lives. They are one of the most common reasons people visit their doctor or a cardiologist.

Palpitations can affect anyone, but they are more common in people who experience stress or anxiety, have certain heart conditions, or consume stimulants like caffeine, alcohol, or nicotine.

Symptoms

Common symptoms

• Feeling like your heart is racing or pounding
• Skipped or extra heartbeats
• Fluttering sensation in the chest
• Pounding feeling in the neck or throat

Symptoms in children

• Children may describe their heart as 'jumping' or 'beeping'
• They may seem scared or anxious for no clear reason
• Sometimes they feel dizzy or tired

Symptoms in older adults

• Older adults may also feel dizzy, lightheaded, or short of breath
• They might notice chest discomfort or a feeling of faintness
• Palpitations can be a sign of an underlying heart condition that needs checking

Causes

Main causes

• Stress, anxiety, or panic attacks
• Caffeine, alcohol, nicotine, or recreational drugs
• Certain medicines like decongestants or asthma inhalers
• Hormonal changes (e.g., pregnancy, menopause)
• Heart rhythm disorders (arrhythmias)
• Overactive thyroid (hyperthyroidism)
• Low blood sugar, dehydration, or electrolyte imbalances

Risk factors

• Anxiety or panic disorder
• Heart disease or previous heart attack
• High blood pressure
• Thyroid problems
• Heavy alcohol or caffeine use
• Smoking or vaping

When to see a doctor

See a doctor urgently if:

• If palpitations are new, severe, or happen with chest pain, fainting, or shortness of breath
• If you have a history of heart disease and notice changes in your palpitations
• If palpitations last for more than a few minutes or keep coming back

Book a routine appointment if:

• If you have mild, occasional palpitations without other symptoms
• If you want reassurance and a check-up to rule out serious causes

Diagnosis

Your doctor will ask about your symptoms, health history, and any triggers. They will listen to your heart and check your pulse. Based on this, they may recommend tests to look for the cause.

Tests that may be done

• Electrocardiogram (ECG) — records the electrical activity of your heart
• Holter monitor — a portable ECG you wear for 24–48 hours
• Echocardiogram — an ultrasound of your heart to check structure and function
• CT scan — detailed X-ray images of your heart and blood vessels

What to expect at your appointment

For a CT scan, you will lie on a table that slides into a large circular machine. The technician will ask you to hold your breath for a few seconds. You may receive a dye (contrast) through a vein to make your heart and vessels clearer. The scan is painless. Preparation may include not eating for a few hours and avoiding caffeine before the scan.

Treatment

Treatment for palpitations depends on the cause. If no serious condition is found, you may not need any treatment. If an underlying problem is discovered, treatment focuses on that cause, such as managing anxiety, adjusting medications, or treating a heart rhythm disorder.

Self-care at home

• Reduce caffeine, alcohol, and nicotine
• Learn stress management techniques like deep breathing, meditation, or yoga
• Stay well hydrated and eat regular meals
• Get enough sleep

Medical treatments

If palpitations are due to a heart rhythm problem (arrhythmia), doctors may prescribe medications to control the heart rate or rhythm. They may also recommend a procedure called catheter ablation to fix abnormal electrical pathways, or a pacemaker if the heart beats too slowly. These treatments are tailored to your specific condition.

When is surgery considered?

Surgery is rarely needed for palpitations alone. It may be considered if there is a structural heart problem, such as a blocked coronary artery or heart valve disease, that is causing the palpitations.

Living with this condition

Most people with palpitations live a normal life. Once a serious cause is ruled out, you can usually continue your daily activities. It helps to note when palpitations happen and what you were doing at the time.

Lifestyle tips

• Avoid known triggers like caffeine, alcohol, and heavy meals
• Manage stress through relaxation techniques or counselling
• Stay active with moderate exercise, but avoid extreme exertion if palpitations are triggered
• Get regular check-ups if you have risk factors

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Limit stimulants. Regular moderate exercise can improve heart health and reduce stress. If your doctor says it's safe, aim for 150 minutes of moderate activity per week.

Mental health and emotional wellbeing

Anxiety can both cause and worsen palpitations. It's common to worry about your heart. Learning to manage anxiety can break the cycle. Therapy, relaxation, and mindfulness can help.

Prevention

Not all palpitations can be prevented, but you can reduce your risk by leading a heart-healthy lifestyle: manage stress, avoid excessive stimulants, stay active, eat well, and get regular check-ups if you have risk factors.

Vaccines

No vaccines are related to palpitations.

Screening programmes

If you have a family history of heart rhythm problems or risk factors like high blood pressure, regular check-ups with your doctor can help catch issues early.

Complications

If left untreated

• If palpitations are caused by a serious arrhythmia, untreated it can lead to stroke, heart failure, or cardiac arrest.
• Rarely, very fast heart rates over a long time can weaken the heart muscle.
• Anxiety about palpitations can affect your quality of life.

Long-term outlook

For most people, palpitations are not dangerous and often go away on their own. With proper diagnosis, any underlying condition can be managed effectively, and you can lead a full, active life. Your healthcare team will work with you to find the best approach.

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