DIAGNOSIS CHECKLIST
for Palpitations

Why: to determine if acute or chronic.

Why: Palpitations are an unpleasant awareness of the beating of the heart, it does not always imply "racing" of the heart.

Why: e.g. an irregular tapping "all over the place" suggests atrial fibrillation; an isolated thump or jump followed by a definite pause on a background of a regular pattern indicates premature beats (ectopics/extrasystoles) usually of a ventricular origin.

Why: Constant problems may signify tachycardia, and that would signify hyperthyroidism, fever or overuse of caffeine and other drugs. Intermittent problems are more likely related to a heart arrhythmia.

Why: e.g. MSG in Chinese food, exercise, anxiety, stress, worry, excitement. Palpitations not related to emotion, fever or exercise suggest an arrhythmia of the heart.

Why: Palpitations in pregnancy are not uncommon.

Why: The toxin from tick bites on the upper chest or back may cause palpitations.

Why: e.g. Rheumatic fever, heart attack, hypertension, cardiomyopathy, stroke (atrial fibrillation increases the risk of stroke 5 fold).

Why: e.g. nasal decongestants; digoxin; almost all anti-arrhythmic drugs (medications taken for abnormal heart rhythms) may worsen existing arrhythmias or provoke new arrhythmias in some people (such as amiodarone, sotalol, verapamil, diltiazem, procainamide, disopyramide, quinidine, lignocaine, flecainide and beta -blockers); ventolin; thyroxine; tricyclic antidepressants.

Why: some people are sensitive to effects of alcohol and experience palpitations as a side effect.

Why: some people are sensitive to effects of nicotine and experience palpitations. Cigarette smoking is a common trigger of paroxysmal supraventricular tachycardia (PSVT) - a type of arrhythmia of the heart.

Why: e.g. cocaine, marijuana - may cause palpitations.

Why: Including coffee, tea, Coke or chocolate. Some people are sensitive to effects of caffeine and experience persistent or intermittent palpitations.

Why: may indicate angina, heart attack, aortic stenosis.

Why: may indicate anxiety with hyperventilation (rapid breathing), mitral stenosis or cardiac failure.

Why: indicates a more severe arrhythmia such as sick sinus syndrome, complete heart block, aortic stenosis or associated cerebrovascular disease.

Why: e.g. must consider bacterial endocarditis, rheumatic fever. A fever itself (from any cause) may cause a sinus tachycardia (increased heart rate) which may be experienced as palpitations.

Why: is characteristic of paroxysmal Supraventricular tachycardia (PSVT).

Why: e.g. palpitations, increased heart rate, preference for cooler weather, increased appetite, weight loss, increased sweating, tremor, nervousness, irritability, diarrhea, lack of menstrual periods, frequent urination.

Why: e.g. palpitations, shortness of breath, swelling of the ankles and lower legs.

Why: e.g. nervousness, shakiness, tremor, restlessness, irritability, insomnia, poor concentration, heart palpitations, racing heart, sweating, dizziness, diarrhea, lump in throat and frequency of urination. Anxiety is a common trigger of paroxysmal supraventricular tachycardia (PSVT) - a type of arrhythmia of the heart.

Why: e.g. paroxysmal episodes of headache, pallor, sweating, chest tightness, tremor and heart palpitations.

Why: e.g. hot flushes, night sweats, heart palpitations, lightheadedness, dry vaginal, dry skin, headaches and sometimes diffuse hair loss.