Heart Palpitations Tests and Diagnosis

The first step your doctor will do in diagnosing your condition is to know whether your palpitations are harmless or are signs of a heart problem. Questions regarding your medical history and symptoms will be asked by your doctor. He then may perform a physical exam and certain diagnostic tests after reviewing your history and symptoms.

The information gathered from your medical history, tests and symptoms may lead your doctor to the cause of your palpitations. If he is not yet 100% sure, your doctor may recommend more tests.

Certain medical professionals may be needed to help diagnose and treat your heart palpitations. They include:

Your primary care physician
Cardiologist – A cardiologist is a physician specializing in the cardiovascular conditions and diseases.
Electrophysiologist – This is also a cardiologist who primarily deals with the electrical system of the heart

Medical History

In order to understand your medical history, your doctor will ask you questions about your palpitations. These questions can involve:

The time when your palpitations began
The duration of your palpitations
The frequency of your palpitations
The manner your palpitations occur – This can include if the palpitations start and stop abruptly
The steadiness or irregularity of your heartbeat during the palpitations
Symptoms that may arise along with the palpitations
The pattern of your palpitations – For example, if the palpitations happen when you drink coffee or exercise or if they occur at a specific time of day

You also may be queried by your doctor regarding your intake of illegal drugs, supplements, alcohol and caffeine.

Physical Exam

During a physical exam, your pulse will be read by your physician to determine the speed of your heart rate and to see if your rhythm is normal. Your doctor will also listen to your heartbeat using a stethoscope. He will also observe for symptoms and signs that can result in palpitations such as an overactive thyroid.

Diagnostic Tests

The most common test for diagnosing palpitations is with an electrocardiogram or EKG. This is a machine that monitors the electrical activity of your heart. The EKG machine displays the rhythm (irregular or stable) and beating of your heart. It also helps show the timing and strength of the electrical impulses as they pass through your heart.

Sometimes the EKG machine may reveal a normal heartbeat but it is useless for detecting the underlying problem that’s causing your palpitations. Blood tests may then be ordered by your doctor if he thinks you have a condition that’s causing your palpitations. The blood tests may help provide more information regarding your heart’s electrical system, function and structure.

Holter or Event Monitor

A Holter monitor is a device that registers the electrical activity of the heart for one to two full days. The patient is placed with electrodes on their chest. The electrodes are connected to wires that connect to portable small recorder which is hung around the patient’s neck, kept in the patient’s pocket or clipped to his/her belt.

The recorder will detect your heart activity while you do your activities for a day or two. You may need to note any symptoms you experience and the time the symptoms arise in a notebook. After a day or two you bring back the recorder and give the notebook to your doctor who will review your results and symptoms.

An event monitor like the Holter monitor is worn by the patient while you do your normal routines. The difference is that an event monitor only monitors the electrical activity of your heart at specific times, not all the time.

The event monitor activates when you push a button in the monitor. It is only activated when you begin to experience symptoms. Some event monitors automatically activate when they sense irregular rhythms of the heart. This device may be worn for weeks or till symptoms show up.


This type of test makes use of sound waves to recreate a moving picture of your heart. The shape and size of your heart as well as your heart valves and chambers can be seen in an echocardiography.

An echocardiography can likewise detect parts of your heart where blood flows poorly, the regions of heart muscle that contract poorly and past injury in the heart muscle due to poor circulation.

Stress Test

There are heart conditions that can be easily diagnosed especially when your heart is beating fast and working hard. A stress test consists of an exercise or series of exercises to let your heart beat fast and work hard. If you are unable to exercise, you may instead take medication that make your heart beat fast and work hard.

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