Diagnosis of Heart Palpitations:

A good medical history and physical exam can separate harmless palpitations from more serious disturbances in heart rhythm. The physical or emotional circumstances surrounding a palpitation often provides clues to the source, as do the patient's medication list and recent use of stimulants or alcohol.

The best way to evaluate a heartbeat disturbance is to document an episode with an electrocardiogram. A portable monitor can record heart rhythm over time, usually 24 to 48 hours.

If rhythm disturbances occur infrequently but are worrisome, a physician may recommend using a device called a transient symptomatic event recorder (known informally as cardiobeeper). Some of these devices resemble sports watches and are worn on the wrist. 

Cardiobeepers may be worn for extended periods. When a heartbeat disturbance occurs, the device is turned on to record the episode. The information is then transferred via the telephone to a physician.

Harmless palpitations generally can be identified as such without sophisticated monitoring. But anytime an unusual or prolonged palpitation causes concern, the episode should be reported to a physician.