Answer
Palpitations usually reflect a variance in one's heart rhythm although sensations felt to be originating from our heart can in fact represent muscle twitches, upper intestinal feelings, etc. At night we are usually free of distractions and heart irregularities are more likely to be felt.
If palpitations are an issue, a work-up usually includes some type of heart monitoring device sent home with the patient to document the true nature of the feelings and allow further evaluation to be tailored from there.
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