Palpitasi

Palpitasi (palpitations) are the subjective sensations of an abnormal heartbeat—such as racing, pounding, fluttering, or an irregular rhythm. They may occur in healthy people or reflect an underlying condition. Most palpitazioni are benign, but they can arise from arrhythmias, electrolyte disturbances, anemia, thyroid disease, anxiety, or stimulant use. Alarm features include chest pain, fainting, shortness of breath, or signs of poor perfusion; such symptoms warrant urgent evaluation.

Common benign triggers include caffeine, nicotine, alcohol, dehydration, stress, and sleep deprivation. Cardiac causes include supraventricular tachycardias, atrial fibrillation or flutter, premature atrial or ventricular contractions, and, less often, ventricular tachycardia. Systemic or metabolic causes encompass anemia, hyperthyroidism, electrolyte disturbances (potassium, magnesium, calcium), fever, or pregnancy. In older adults or those with heart disease, palpitations may signal ischemia or heart failure.

Evaluation starts with history and physical examination, followed by an electrocardiogram (ECG). If symptoms are intermittent, ambulatory monitoring (Holter or event recorder) may be needed. Blood tests assess thyroid function, hemoglobin, and electrolytes. Imaging, such as echocardiography, is considered when structural heart disease is suspected. Exercise testing may help diagnose exercise-induced ischemia or arrhythmias.

Management targets the underlying cause and symptom burden. Stable patients may benefit from avoiding triggers and reassurance. Vagal maneuvers can terminate certain rapid rhythms under supervision. Medications such as beta-blockers or calcium channel blockers control rate and symptoms; antiarrhythmic drugs or ablation are options for recurrent arrhythmias. Correcting electrolyte or thyroid abnormalities improves most cases; ischemia or heart failure requires disease-specific treatment. Prognosis depends on the underlying condition.