Red flags & when to go in person for Palpitations

Audience: adult

Palpitations are sensations of a fast, fluttering, or pounding heartbeat. They can be caused by many things, such as stress, caffeine, or exercise, and often are harmless. However, palpitations can sometimes signal a serious heart problem. Telemedicine can help you discuss your symptoms, review your health history, and decide if you need urgent care. It is important to recognize red flags that require in-person evaluation, such as chest pain, fainting, or severe shortness of breath. This guide explains when telemedicine is appropriate for palpitations and when you should seek immediate medical attention in person. Understanding these signs can help you get the right care quickly and safely.

Red flags — go in person / ER

• Chest pain or pressure with palpitations — seek emergency care immediately.
• Fainting or near-fainting episodes accompanying palpitations — go to the nearest emergency department.
• Severe shortness of breath or difficulty breathing with palpitations — get urgent in-person evaluation.

What telemedicine can do

• Initial assessment of palpitations without severe symptoms.
• Review of medical history and lifestyle factors related to palpitations.
• Advice on symptom management and when to seek in-person care.
• Follow-up visits after initial evaluation or treatment.

What telemedicine cannot do

• Emergency symptoms such as chest pain, fainting, or severe shortness of breath.
• Need for urgent diagnostic tests like ECG or blood work.
• Treatment requiring immediate intervention or hospital admission.
• Evaluation of trauma-related palpitations or severe arrhythmias.

What Are Palpitations?

Palpitations feel like your heart is beating too fast, skipping beats, or fluttering. You might notice them during rest or activity. Common causes include stress, anxiety, caffeine, or certain medications. Most palpitations are not dangerous and go away on their own.

When to Use Telemedicine for Palpitations

Telemedicine can be a good first step if you notice palpitations without other serious symptoms. A healthcare provider can ask about your symptoms, medical history, and lifestyle. They may help identify triggers and suggest simple ways to manage palpitations. Telemedicine is helpful for follow-up visits or when you need advice but do not have urgent symptoms.

Red Flags That Need In-Person Care

Some symptoms with palpitations may indicate a serious problem. You should seek emergency care if you experience:

These signs may require tests like an electrocardiogram (ECG) or urgent treatment.

What to Expect During an In-Person Visit

If you go to a clinic or hospital, the healthcare team may perform a physical exam and heart tests. These can include ECG, blood tests, or heart monitoring. They will check for heart rhythm problems, structural heart disease, or other causes. Based on results, they may recommend treatment or specialist referral.

Managing Palpitations at Home

If your palpitations are mild and no red flags are present, you can try:

Keep track of your symptoms and triggers to discuss with your healthcare provider during telemedicine or in-person visits.

How to prepare for your tele-visit

• Note when palpitations started and how often they occur.
• Record any other symptoms like chest pain, dizziness, or shortness of breath.
• List current medications, supplements, and caffeine or alcohol intake.
• Prepare questions or concerns about your symptoms.
• Ensure a quiet, private space with good internet connection for the tele-visit.

After your tele-visit

• Follow provider’s advice on managing symptoms at home.
• Schedule in-person evaluation if red flags develop or symptoms worsen.
• Keep a symptom diary to track palpitations and triggers.
• Take prescribed medications as directed, if any.
• Contact healthcare provider if new or severe symptoms appear.

FAQs

Can stress cause palpitations?

Yes, stress and anxiety are common causes of palpitations. They can trigger your heart to beat faster or irregularly. Managing stress through relaxation techniques may help reduce palpitations.

Are palpitations dangerous?

Most palpitations are harmless, especially if you have no other symptoms. However, palpitations accompanied by chest pain, fainting, or severe shortness of breath may indicate a serious condition and require urgent care.

What tests might be done for palpitations?

In-person tests can include an electrocardiogram (ECG) to check your heart rhythm, blood tests, or heart monitoring over time. These help identify any underlying heart problems.

Can telemedicine diagnose heart problems causing palpitations?

Telemedicine can help assess your symptoms and decide if you need further tests or in-person care. However, it cannot perform physical exams or diagnostic tests needed to confirm heart conditions.

When should I go to the emergency room for palpitations?

Go to the emergency room if you have palpitations with chest pain, fainting, severe shortness of breath, or if your heart is beating very fast or irregularly for several minutes.

Sources

1. Palpitations — MedlinePlus | U.S. National Library of Medicine.
2. Heart palpitations: When to worry — Mayo Clinic.
3. Arrhythmias (Heart Rhythm Disorders) — Centers for Disease Control and Prevention (CDC).
4. Palpitations: Causes and Treatment — Merck Manuals: Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience any emergency symptoms or have concerns about your health, seek immediate medical attention from a healthcare professional in person.