palpitations ultrasound explained

Overview

Palpitations are when you feel your heart beating too fast, too hard, skipping a beat, or fluttering. An ultrasound of the heart (called an echocardiogram) uses sound waves to create pictures of your heart. Doctors use it to check the structure and function of your heart when you have palpitations.

Palpitations are very common. Most people experience them at some point.

Anyone can have palpitations, but they are more common in people with anxiety, stress, or certain heart conditions.

Symptoms

Common symptoms

• Feeling of skipped heartbeats
• Racing or pounding heart
• Fluttering in the chest

Symptoms in children

• Children may describe a 'jumping' or 'flip-flopping' feeling in the chest.
• They might not be able to describe it well; look for signs like clutching their chest or shortness of breath.

Symptoms in older adults

• Older adults may experience dizziness, shortness of breath, or chest discomfort along with palpitations.
• They may have more underlying heart conditions that need checking.

Causes

Main causes

• Stress and anxiety
• Caffeine, alcohol, or nicotine
• Hormonal changes (e.g., pregnancy, menopause)
• Electrolyte imbalances (e.g., low potassium or magnesium)
• Heart conditions (e.g., arrhythmias, valve disease, cardiomyopathy)

Risk factors

• High blood pressure
• Diabetes
• Obesity
• Family history of heart disease
• Sleep apnea

When to see a doctor

See a doctor urgently if:

• If you have chest pain, fainting, or severe shortness of breath along with palpitations, call emergency services immediately.

Book a routine appointment if:

• If palpitations occur often or bother you.
• If you have a known heart condition.
• If you are concerned about any change in your heartbeats.

Diagnosis

Your doctor will start with a detailed history and physical exam. They may order tests including an electrocardiogram (ECG) and an echocardiogram (ultrasound of the heart).

Tests that may be done

• Electrocardiogram (ECG) – records the heart's electrical activity.
• Echocardiogram (ultrasound) – shows the heart's structure and function.
• Holter monitor – a portable ECG worn for 24 to 48 hours to capture palpitations as they happen.
• Blood tests – to check for electrolyte imbalances, thyroid problems, or other conditions.

What to expect at your appointment

For an echocardiogram, you will lie on a table while a technician moves a small device (transducer) over your chest. It is painless and takes about 30 to 60 minutes. You may need to change into a gown.

Treatment

Treatment depends on the cause. Most palpitations do not need specific treatment. If an underlying cause is found, your doctor will treat that condition.

Self-care at home

• Reduce or avoid caffeine, alcohol, and nicotine.
• Manage stress with relaxation techniques like deep breathing or meditation.
• Stay well hydrated.
• Get enough sleep each night.

Medical treatments

If palpitations are caused by an arrhythmia (irregular heartbeat), your doctor may recommend medications to control the heart rate or rhythm. They might also suggest a procedure like catheter ablation to correct the rhythm. Always follow your doctor's advice – do not stop or start any medications without their guidance.

When is surgery considered?

Surgery is rarely needed for palpitations alone. It may be considered if there is a serious structural heart problem, such as a faulty heart valve that needs repair or replacement.

Living with this condition

For most people, palpitations are not a sign of a serious problem. You can live a normal life by avoiding triggers and managing stress.

Lifestyle tips

• Limit caffeine, alcohol, and nicotine.
• Quit smoking if you smoke.
• Exercise regularly with your doctor's approval.
• Practice mindfulness or gentle yoga to reduce anxiety.

Diet and exercise

Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Stay active with moderate exercise like walking or swimming for about 150 minutes per week. Always consult your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Palpitations can cause worry or anxiety. It is normal to feel concerned. If anxiety is affecting your daily life, talk to your doctor. They can refer you to a mental health professional. If you are in crisis, contact a crisis support line immediately.

Prevention

You cannot always prevent palpitations, but you can lower your risk by avoiding triggers and managing health conditions like high blood pressure or diabetes.

Complications

If left untreated

• If a serious heart condition is missed, it could lead to complications like stroke or heart failure.
• However, most palpitations are not dangerous.

Long-term outlook

For the vast majority of people, palpitations are harmless and do not affect long-term health. If a treatable cause is found, the outlook is often very good with proper care.

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