Stages of palpitations

Palpitations do not have stages like a long-term disease. It helps to think in terms of how an episode behaves and how worrying the cause is.

Pattern of an episode

1. Trigger: caffeine, stress, exercise, lack of sleep or illness
2. Onset: awareness of the heartbeat, which may start suddenly or build up
3. Peak: fast, pounding or irregular beats, often with anxiety
4. Settling: the rhythm returns to normal on its own or with a simple manoeuvre
5. Aftermath: tiredness, a little chest discomfort, or fear of another episode

How doctors group the concern

• Reassuring pattern: brief episodes, normal ECG, no heart disease, clear trigger
• Needs testing: frequent episodes, episodes lasting longer, or a family history of heart rhythm problems
• Urgent pattern: palpitations with chest pain, fainting, breathlessness or a known heart disease

Over time

Ectopic beats may come and go over years. Atrial fibrillation can start in episodes (paroxysmal) and later become persistent, which is why checking it early matters.

Ayurvedic view

Ayurveda does not describe stages of palpitations in this way. This is a modern clinical description.

Tests that guide the next step

ECG, Holter monitor, echocardiogram, thyroid tests, blood counts and electrolytes.

See a doctor if episodes are increasing in number or length, or if you notice an irregular pulse.

When to get help

See a doctor if palpitations are new, frequent, last more than a few minutes, or come with dizziness, chest discomfort or breathlessness. An ECG, simple blood tests and a heart rhythm monitor can usually find the cause. Call 112 for chest pain, fainting or severe breathlessness.

Remember

The pattern of an episode tells your doctor as much as the test.