When your heart skips a beat

• Palpitations is one of the most common medical complaints worldwide. Most of the time it is harmless but it can causes considerable distress to a person.
• Palpitations can occur when one is at rest or during activity. Some people notice them when they are getting up after lying down, sitting or when they bend over for long periods.
• Allow your doctor to take a thorough history of your palpitations including how long you have had them, when they occur, if they are associated with certain activities and details about drugs, including social ones like alcohol, illicit ones and therapeutic ones like those for asthma.
• The doctor should run a physical examination to check if you have any obvious signs of heart abnormalities, goitre (thyroid problem), anaemia and high blood pressure. At this stage he or she will decide which investigations, if any, are necessary.
• Usually investigations are reserved for people who get palpitations almost daily basis. Most palpitations, which only last a few seconds, and occur irregularly, do not need any further investigation.
• If you have persistent palpitations the doctor may perform an ECG (Electrocardiogram), which is a special test that checks for abnormal heart pumping.

Most of the time, we go about our daily lives blissfully unaware of the numerous mechanisms going on inside our bodies.

However, once in a while, we become aware of the activity of our hearts due to rapid pounding in your chest or when your heart has literally skipped a beat.

These are known as palpitations.

It is one of the most common medical complaints worldwide. Most of the time it is harmless but it can causes considerable distress to a person.

Palpitations can occur when one is at rest or during activity. Some people notice them when they are getting up after lying down, sitting or when they bend over for long periods.

What would cause a normally docile heart to pound away in a seemingly reckless manner? How should your doctor handle palpitations?

First, allow your doctor to take a thorough history of your palpitations including how long you have had them, when they occur, if they are associated with certain activities and details about drugs, including social ones like alcohol, illicit ones and therapeutic ones like those for asthma. Be sure to also inform your doctor of any stresses in your life.

The doctor should run a physical examination to check if you have any obvious signs of heart abnormalities, goitre (thyroid problem), anaemia and high blood pressure. At this stage he or she will decide which investigations, if any, are necessary.

Usually investigations are reserved for people who get palpitations almost daily basis. Most palpitations, which only last a few seconds, and occur irregularly, do not need any further investigation.

If you have persistent palpitations the doctor may perform an ECG (Electrocardiogram), which is a special test that checks for abnormal heart pumping.

This can be done at the doctors office. An ECG may be accompanied by an Echocardiogram, which is a special test that visualises the different parts of the heart for any physical abnormalities.

Monitoring

Since most palpitations occur on and off, and are unlikely to occur in the doctor’s office, you may need to wear a special device to allow for continuous heart monitoring for several days in your usual home and work environment.

If need be, the doctor may do laboratory tests to check for anaemia, thyroid function, calcium levels and other natural salts in the body.

Pregnant women need to be particularly keen about palpitations and must mention them to their obstetrician.