Palpitation can be defined as Unpleasant awareness of forceful, rapid or irregular beating of the heart.
The main characteristic of palpitation is feeling that your heart is beating too quickly or not regularly.
Palpitations is one of the most common symptom patients complaining.
In 81 % of palpitations is caused by arrythmia.
Palpitations usually benign, but some cases, it can be caused by life threating arrythmias.
In many cases, Best diagnostic test to evaluate Palpitation is ECG.
If palpitations lasts less then 5 minutes and Person has family or personal history of Panic disorder, palpitation can be because of fear and stress and not because of arrythmia.
Palpitations that start and stop abruptly suggests supraventricular and ventricular tachycardia.
If termination of palpitation possible using vagal maneurs, e.g. Valsalva maneur, it suggests supraventricular tachycardia.
Valsalva maneuver is performed by a forceful attempt of exhalation. closing one's mouth and pinching one's nose shut while expelling air out as if blowing up a balloon.

Three common description exist of Palpitations:
1. Flip-flopping or start and stop, such type of palpitation commonly caused by premature contraction of atrium or ventricle.
Premature ventricular contractions are extra, abnormal heartbeats that begin in the ventricles, and disrupt your regular heart rhythm, sometimes causing you to feel a skipped beat.
2. Rapid Flattering in the chest, suggests supraventricular or ventricular arrhythmias, including sinus tachycardia. .
If fluttering is irregular nature, then it suggests atrial fibrillation.

3. Pounding in the neck , such type of palpitation occurs when the right atrium contracts against closed tricuspid valve.
If palpitations are associated with chest pain, it indicates ischemic heart disease.
If chest pain relieved by leaning forward it can be pericarditis.
If palpitations are accompanied by light-headedness and presyncope it suggest hypotension and can be dangerous and life threatening.
If palpitations occurs during physical exertion it can be hypertrophic cardiomyopathy.
If palpitation was preceded by vomiting and diarrhea, it can be caused by electrolyte imbalance.
Weight loss, heat intolerance and palpitations indicates hyprthiroidism.
Palpitations plus flushing, episodes of hypertension, anxiety, sweating, headaches it can indicate pheochromocytoma.
Energy drinks, cigarette and e cigarettes can also cause palpitations especially among Youngs.
Caffeine, tea, coffee, marijuana, Cocaine and amphetamines, also cause palpitations.
Treatment:
Treatment of palpitation is depend on the underlying cause.
Radiofrequency ablation can cure most types of supraventricular and many types of ventricular tachycardias.



By Johnorchard - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=91769052