Please interpret my ECG for heart palpitations.

Q. ECG report shows down spikes with heart palpitations. Please explain my report.

Answered by
Dr. Yermal Tanmai Deelip
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 21, 2020 and last reviewed on: Jun 23, 2023

Hello doctor,

I had heart palpitations every day and ECG has picked up some downward spikes when I feel a palpitation. Please explain my ECG.



Welcome to

I have gone through your query that you frequently have palpitations. But I am sorry to tell you that I am unable to see the ECG image you have attached, it is not getting downloaded probably due to some error or a corrupt file. I kindly request you to please attach a new image of your ECG along with a few more details about your present symptoms. Do you have any known cardiac disease? Whenever you get palpitations do you have any other associated cardiac symptoms like chest pain, shortness of breath, giddiness, or sweating? During palpitations do you feel increased heartbeats or a missing/skipped beats or just a bounding pulse? Do you have anxiety or stress? Kindly get back with the above details and a new ECG image for further discussion and management strategy.

Thank you doctor,

It feels like my heart jumps a beat but no pain. It is happening many times a day. I managed to pick it up about three times in the ECG. Each time you can see the ECG downwards when it happens.



Welcome back to

Now I could see the images. (attachment removed to protect patient identity). Your ECG recordings are suggestive of ventricular premature complexes i.e. VPC. These are premature extra beats from your heart which are different from your normal sinus beats and most likely that these extra beats are the reason for your palpitations. In many of the patients, these VPC's are benign i.e. harmless and need not worry. But in a few patients, it has to be evaluated and further treated as they may be due to some structural heart disease. So just relax and do not worry much about your symptoms. Whenever possible you need to undergo two tests 24 hours Holter monitoring and echocardiogram of your heart. It is not an emergency as far as your symptoms are not troubling and are very frequent and associated with other cardiac symptoms. You also need to maintain your electrolytes properly like sodium and potassium intake. You need to stop any addictions if you have like smoking and alcohol. Your VPC's are not very frequent, so I do not think you need to start any treatment before echo and Holter. In case you are unable to get it tested due to COVID 19 lockdown and your symptoms are very frequent then you please get back to me, I will advise some tablets to be started for the time being.

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