Family Doctor Health Advisor

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Palpitations

Palpitations are an awareness of unusually rapid, strong, or irregular beating of the heart. It is normal for the heart rate to speed up during strenuous exercise, and you may feel your heart "thumping" for some minutes afterwards. This is usually no cause for concern. In most cases, palpitations that occur at rest are caused by the effect of drugs such as caffeine or nicotine or may simply be due to anxiety. However, in a small proportion of people, palpitations that occur at rest are a symptom of an underlying illness. If you have recurrent palpitations that have no obvious cause or that are associated with chest pain or shortness of breath, you should always seek medical advice.

1 Do you experience any of the following when you are having palpitations?

  • Pain in the chest or neck
  • Sudden, severe shortness of breath
  • Feeling faint or passing out

Yes 2 No 3

Caffeine

Caffeine is present in varying amounts in tea, coffee, chocolate, and some soft drinks, notably cola. Filter coffee contains about twice as much caffeine as instant coffee, which has about twice the amount of caffeine that tea contains.

Caffeine stimulates the nervous system, making you feel more energetic. It also increases the amount of urine produced. Small amounts of caffeine do no harm, but in large doses, it may produce symptoms such as palpitations, trembling, and sleeplessness. Some people are more likely to develop these symptoms than others.

Try to gradually cut down your caffeine intake to 2 cups of coffee a day or less. Sudden withdrawal of caffeine may cause symptoms such as headaches.

Ambulatory electrocardiography

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Ambulatory ECG tracing

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Using a Holter monitor
The device is worn under clothing. This trace () produced by the device shows an early abnormal beat (ectopic beat), which coincides with a symptom marker.

In ambulatory electrocardiography (ECG), a wearable device called a Holter monitor records the electrical activity of the heart by means of electrodes attached to the chest. The device is usually worn for 24 hours or longer and detects intermittent arrhythmias (abnormal heart rates and rhythms). Whenever symptoms occur, you press a button, which adds a mark to the recording. The recording is then analysed to see if there are any periods of arrhythmia and if they coincide with the marks denoting symptoms.

Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.

The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.

Publication Date: 31 March 2009
Authorised By: RACGP

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