Pointers in the Description of Palpitation
| Type of palpitation | Subjective description | Heartbeat | Onset and termination | Trigger situations | Possible associated symptoms |
|---|---|---|---|---|---|
| Extrasystolic | ‘Skipping/missing a beat’, ‘sinking of the heart’ | Irregular, interspersed with periods of normal heartbeat | Sudden | Rest | — |
| Tachycardiac | ‘Beating wings’ in the chest | Regular or irregular, markedly accelerated | Sudden | Physical effort, cooling down | Syncope, dyspnoea, fatigue, chest pain |
| Anxiety-related | Anxiety, agitation | Regular, slightly accelerated | Gradual | Stress, Anxiety attacks | Tingling in the hands and face, Lump in the throat, atypical chest pain, sighing dyspnoea |
| Pulsation | Heart pounding | Regular, normal frequency | Gradual | Physical effort | Asthenia |
| Type of arrhythmia | Heartbeat | Trigger situations | Associated symptoms | Vagal manoeuvres |
|---|---|---|---|---|
| AVRT, AVNRT | Sudden onset regular with periods of elevated heart rate | Physical effort, changes in posture | Polyuria, neck pulsation | Sudden interruption |
| Atrial fibrillation | Irregular with variable heart rate | Physical effort, cooling down, post meal, alcohol intake | Polyuria | Transitory reduction in heart rate |
| Atrial tachycardia and atrial flutter | Regular (irregular if A-V conduction is variable) with elevated heart rate | Transitory reduction in heart rate | ||
| Ventricular tachycardias | Regular with elevated heart rate | Physical effort | Signs/symptoms of haemodynamic impairment | No effect |
Source: Raviele A, Giada F, Bergfeldt L, et al. (2011) Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace 13, 920–934. Reproduced with permission of Oxford University Press.