Heart
Palpitations
A sensation that your heart is racing, fluttering, pounding, or skipping a beat.
Palpitations — a racing, fluttering, or irregular heartbeat sensation — are a common presentation with causes ranging from benign lifestyle triggers to significant arrhythmias. Specialist evaluation identifies underlying causes and determines necessary treatment.
Book a Consultation
Palpitations can range from harmless flutters to warning signs of underlying arrhythmias that require medical evaluation.
Common Causes
- Physiological triggers: caffeine, alcohol, nicotine, exercise, dehydration, anxiety
- Medical causes: atrial fibrillation, SVT, ventricular ectopics, hyperthyroidism, anaemia
- Medication-related: beta-agonist inhalers, decongestants, digoxin toxicity
- Structural: cardiomyopathy and valve disease
Diagnostic Clues
- Sudden-onset regular rapid palpitations suggest SVT
- Irregular sustained rapid rhythm indicates atrial fibrillation
- Isolated skipped beats suggest premature contractions
- Exercise-triggered palpitations may signal ventricular arrhythmias
Diagnosis
- 12-lead ECG
- Holter monitoring (24–48 hours)
- Event recorders for prolonged monitoring
- Implantable loop recorder for rare episodes
- Echocardiography
- Thyroid and metabolic blood tests
Treatment Options
- Lifestyle modifications: reduce caffeine and alcohol, manage stress, stay hydrated
- Antiarrhythmic medications
- Catheter ablation
- ICD implantation
- Vagal manoeuvres
- Targeted therapy for underlying metabolic causes
Emergency Warning Signs
Call 995 immediately for syncope, severe chest pain, breathlessness at rest, or haemodynamic instability.
Concerned About Palpitations?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.