Palpitation is a very common symptom described by patients, who also refer to as “fluttering”, “missing or extra heart beats” or “butterflies in the chest”. The more technical definition of a heart palpitation is the sensation of the heart beating irregularly, out of sync with the normal heart beating or at an unexpected faster rate. Finally, over the recent years the use of smart devices such as Apple watches and fit bits are increasing people’s awareness of their heartbeats, even in the absence of significant symptoms.
The vast majority of palpitations are benign in nature and you do not need to see a doctor to investigate them. It is common for a normal heart to occasionally beat irregularly and this can happen hundreds of times during the day with most of us not even being aware of it. Stress, lack of sleep and excessive intake of caffeine drinks might contribute to increased extra heartbeat sensations. Currently, many patients are experiencing increased palpitations post COVID-19 infection, which most of the time do not represent significant heart damage caused by the virus.
So, when could a sensation of palpitations be a worrying sign? Firstly, if you have a known heart condition such as heart failure or angina, persistent palpitations could be a sign of more nasty heart rhythms and they should be investigated. Also, if palpitations are associated with other symptoms such as significant chest pains or the sensation of near collapse (syncope) they should also be discussed with your doctor, particularly if there is a sustained fast heart beating (when you are not exercising). Finally, a sensation of a persistently irregular heartbeat or pulse, especially if you are over 65 and suffer from high blood pressure, might be a sign of Atrial Fibrillation, a common type of arrhythmia which can increase the risk of stroke. The diagnosis of Atrial Fibrillation requires a test called an ECG (electrocardiogram) and you should speak to your doctor about it.
Regardless of the type of palpitations, if they are persistent (over many months) and disturbing your quality of life, you might benefit from finding out why that is the case and discuss potential treatment options with your doctor.