What Is Involved in the Management of Severe Palpitations?

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  • Written By: C. Webb
  • Edited By: Daniel Lindley
  • Last Modified Date: 01 April 2020
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A palpitation is an abnormal heartbeat that can be too fast, slow, or out of rhythm. In some cases the palpitations are not noticed, while in other cases they are felt by the person experiencing them. Duration of palpitation episodes can last from a few seconds to several hours, depending on the cause and circumstances surrounding their existence. Management of severe palpitations depends on the cause as well as the patient's ability to tolerate them.

Severe palpitations warrant medical investigation. Once the cause is discovered, a course of management and treatment can begin. Possible management methods include medication, changes in diet, and mental health treatment.

Determining the cause of palpitations is the first step in management. The patient may be asked to wear a small medical device for several hours, days, or weeks. Each time palpitations are triggered, the patient pushes a button on the monitor to mark it on the recording. When the episode stops, the patient pushes the button again. An analysis of the monitor recordings is then done to determine the frequency and possible cause of the severe palpitations.

Other medical tests, including an ECG and an ultrasound to study the heart's structure, are helpful in the management of severe palpitations. Discovering the underlying cause through these tests allows a treatment plan to be formed. Blood tests can identify underlying medical issues, such as anemia, that can cause palpitations.


Nicotine use, alcohol consumption, and illegal drug use are all reported triggers of severe palpation episodes. In addition, medical conditions such as hyperthyroid disease and anxiety are often found to be the triggers. The management of palpitations caused by drugs, alcohol, or caffeine includes the elimination of such substances from the body. Once the elements are removed, the palpitations should resolve. Switching to decaffeinated beverages is not always effective, and in some cases, all forms of caffeine, including chocolate, coffee, and soda, are eliminated from the diet.

If the cause of severe palpitations is an underlying heart condition, such as supraventricular tachycardia, the condition is managed with medications and lifestyle changes. Reducing caffeine intake, stress reduction, and proper amounts of rest will help manage the SVT palpitation episodes. Other heart conditions found to be the cause of palpitations are also treated in the effort to manage them.

Management of severe palpitations caused by stress, anxiety, or other mental conditions is typically handled by a mental health professional. Counseling appointments, anxiety medications, and relaxation techniques can contribute to the reduction or elimination of palpitations. Stress relief through classes in yoga and meditation can also help eliminate anxiety-triggered palpitations.


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