Palpitations sensation is among the leading sympomts that urge a patient to seek an expert opinion. A variety of causes may provoke this symptom (as if heart is pounding or racing or beating inconsistently) which, in cases, might be really unpleasant. In most instances it is of benign (e.g. isolated premature supraventricular beats) or even due to extracardiac origin like anxiety. Nutritional habits such as consumption of caffeine, alchocol or even cocoa may aggravate this unpleasant symptom.

In cases of acute presentation, consulation of a cardiologist may be needed. In the majority of the cases, full work-up is conducted in a non-urgent basis in order to reveal the cause; which is sometimes not possible to achieve. It should be noted that timely diagnosis of specific arrhythmia types, like atrial fibrillation, may be of importance for long-term clinical course and prognosis.

The first step for the evaluation of palpitations, after medical history taking, is physical examination and electrocardiography. Further evaluation may involve an echocardiogram, lab tests (e.g. full blood cound and thyroid hormones) and/or prologned heart rhythm evaulation with special devices (e.g. 24- or 48- hour Holter monitoring).