‘Palpitations’ is the term used to describe the sensation of an abnormal heartbeat, often described by patients as, forceful, rapid or irregular beating of the heart, a rapid fluttering sensation in the chest, flip flopping in the chest, or a pounding sensation in the chest or neck. This group of symptoms accounts for a very large number of presentations to the doctor.

This symptom can have any of a number of potential causes, which include:

  • Heart disease
  • Some medications
  • Psychiatric conditions
  • Recreational drugs
  • Other medical disorders


It is rare for a doctor to have the opportunity to examine a patient during an episode of palpitations, and further actions are directed towards gathering clues about the potential cause.

Your cardiologist will ask lots of questions about your symptoms, perform a physical examination and an ECG, and review recent screening blood tests.

Other testing may include echocardiography, Holter monitoring, and rarely, invasive electrophysiological testing, as determined by your specialist.

The treatment of this symptom will depend on the cause. In about half of all patients who present to the doctor with this symptom, a diagnosis is eventually made.