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Cardiolucent

Condition

Palpitations (irregular heartbeats)

Symptoms & Risk Factors

Palpitations are the sensation of feeling your own heartbeat — often described as fluttering, pounding, skipping, racing, or simply an awareness of the heart in the chest. They can be entirely benign or the first clue to an important arrhythmia, and the sensation itself does not reliably distinguish between the two. The diagnostic challenge is that palpitations tend to come and go, often disappearing by the time someone reaches the office. Capturing the actual rhythm during a symptomatic episode is what answers the question definitively. Dr. Kedan combines extended ambulatory monitoring, echocardiography, and a careful search for triggers and structural drivers so that the eventual treatment plan — whether reassurance, lifestyle change, medication, or referral for ablation — is grounded in real data rather than guesswork.

What Cardiolucent Evaluates

  • 12-lead EKG to capture rhythm and look for structural clues
  • Extended ambulatory rhythm monitoring — 2-week patch or longer-term loop recorder when symptoms are infrequent
  • Echocardiography with POCUS for structural drivers of arrhythmia
  • Thyroid function, electrolytes, magnesium, and kidney studies
  • Hemoglobin and metabolic panel to rule out anemia and metabolic triggers
  • Trigger review including caffeine, alcohol, supplements, decongestants, and sleep patterns
  • Wearable and personal-device data integration when available (Apple Watch, KardiaMobile, Fitbit)
  • Coordination with electrophysiology at Cedars-Sinai when ablation or device therapy is appropriate

What Patients Describe

  • Fluttering, pounding, or thumping in the chest or neck
  • A skipped or extra beat followed by a stronger beat
  • A sudden racing heart that starts and stops abruptly
  • Awareness of an irregular, chaotic rhythm
  • Palpitations that come on with caffeine, alcohol, stress, or after meals
  • Symptoms that occur at rest, lying on the left side, or while falling asleep
  • Lightheadedness, chest discomfort, or shortness of breath during episodes
  • Palpitations with fainting or near-fainting are a serious finding and deserve urgent evaluation

Possible Underlying Causes

  • Premature atrial or ventricular contractions (PACs/PVCs) — often benign but sometimes symptomatic
  • Atrial fibrillation or atrial flutter
  • Supraventricular tachycardia (SVT, AVNRT, AVRT)
  • Ventricular tachycardia (less common but serious)
  • Sinus tachycardia from anemia, dehydration, fever, or anxiety
  • Thyroid disease, particularly hyperthyroidism
  • Electrolyte abnormalities (low potassium or magnesium)
  • Caffeine, alcohol, stimulant medications, decongestants, and certain supplements
  • Obstructive sleep apnea
  • Structural heart disease including cardiomyopathy and valvular disease

How We Investigate

Dr. Kedan's first goal is to capture the actual rhythm during a symptomatic episode, since that single piece of data usually decides the treatment path. A 2-week ambulatory patch is well tolerated and yields far more than a single in-office EKG, and longer-term loop recorders are used when symptoms are infrequent. POCUS at the visit answers structural questions immediately, while labs identify reversible drivers like thyroid disease or electrolyte imbalance. When a treatable arrhythmia is identified, Dr. Kedan coordinates with electrophysiology at Cedars-Sinai for ablation candidacy; for benign findings, the concierge model supports the close follow-up that quality of life often requires.

Common Questions

Frequently Asked Questions

What do palpitations actually mean?
Palpitations are the sensation of feeling your own heartbeat — often described as fluttering, pounding, skipping, or racing. They can range from completely benign extra beats to important arrhythmias that need treatment. The sensation alone does not determine which category you are in, which is why an objective evaluation matters.
Are palpitations always a sign of something serious?
No. Many people experience occasional extra beats (premature atrial or ventricular contractions) that feel dramatic but pose little risk. That said, palpitations can also be the first clue to atrial fibrillation, supraventricular tachycardia, or, less commonly, more serious rhythms. Dr. Kedan distinguishes between these by capturing the rhythm during a symptomatic episode.
What can trigger palpitations?
Common triggers include caffeine, alcohol, dehydration, poor sleep, intense exercise, stress, thyroid disease, anemia, and certain medications and supplements. Hormonal changes and reflux can contribute as well. Identifying triggers is part of the workup, even when the underlying rhythm is benign.
How will Dr. Kedan figure out what is causing my palpitations?
Evaluation typically begins with a 12-lead EKG, blood work including thyroid and electrolyte studies, and echocardiography to assess heart structure. Because palpitations often occur intermittently, an extended monitor — frequently a 2-week wearable patch — is used to capture rhythm during your normal life. POCUS during the visit adds immediate structural information.
Do I need to wear a heart monitor for that long?
Longer monitoring substantially increases the chance of catching an arrhythmia that comes and goes. A 2-week patch is typically well tolerated and provides far more diagnostic yield than a single in-office EKG. In some cases, longer-term loop recorders are used when symptoms are very infrequent.
When are palpitations an emergency?
Palpitations accompanied by chest pain, fainting, severe shortness of breath, or a sustained very rapid heart rate that does not resolve warrant an immediate 911 call. A brief episode that resolves with no other symptoms is rarely an emergency but still deserves evaluation. When unsure, err on the side of urgent evaluation.
How are palpitations treated?
Treatment depends on the underlying rhythm. Benign extra beats often need only reassurance, hydration, and trigger management. Atrial fibrillation requires rhythm or rate control plus stroke prevention, while supraventricular tachycardias and other specific arrhythmias may benefit from medications or catheter ablation. Dr. Kedan coordinates with electrophysiology when ablation is the right answer.
Will lifestyle changes help?
Often yes. Reducing caffeine and alcohol, improving sleep, treating sleep apnea, managing stress, and ensuring good hydration can substantially decrease the frequency of benign palpitations and even the burden of some arrhythmias. These changes are simple but consistently effective when applied seriously.
Should I just live with palpitations if my doctor says they are benign?
Even benign palpitations can affect quality of life, and they sometimes evolve over time. A formal evaluation, periodic check-ins, and a clear plan for what to do if symptoms change are reasonable for most patients. Schedule a consultation with Dr. Kedan if your palpitations are frequent, frightening, or new — peace of mind is part of the value of getting a thorough answer.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.