Palpitations

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Author: Paul D A Reavley / Editor: Jason M Kendall / Reviewers: Stewart McMorran, Peter Lynas, Joshua Davison / Codes: / Published: 07/07/2020 / Reviewed: 03/05/2024

This module is about assessment and management of patients presenting with palpitations to the emergency department (ED).

After completing this session you will be able to:

  • Recognise the common causes of palpitations
  • Understand the pathophysiology of palpitations
  • Describe the initial approach to a patient with palpitations in the ED
  • Elicit an appropriate history in patients presenting with palpitations
  • Demonstrate the discriminating physical signs associated with different causes of palpitations
  • Plan and interpret appropriate investigations in patients with palpitations in order to achieve a diagnosis.

References

  1. Bikkina M, Larson MG, Levy D. Prognostic implications of asymptomatic ventricular arrhythmias: the Framingham Heart Study. Ann Intern Med. 1992 Dec 15;117(12):990-6.
  2. Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996 Feb;100(2):138-48.
  3. National Institute for Health and Care Excellence (NICE). Palpitations. NICE CKS, Revised in April 2020.
  4. Thavendiranathan P, Bagai A, et al. Does this patient with palpitations have a cardiac arrhythmia? JAMA. 2009 Nov 18;302(19):2135-43.
  5. Raviele A, Giada F, Bergfeldt L, Blanc JJ, et al. Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace. 2011 Jul;13(7):920-34.
  6. Soar J, et al. Resuscitation Council guidelines (Peri-arrest arrhythmias), 2021.
  7. Chieng D, Canovas R, Segan L, Sugumar H, et al. The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank. Eur J Prev Cardiol. 2022 Dec 7;29(17):2240-2249.
  8. Abbott AV. Diagnostic approach to palpitations. Am Fam Physician. 2005 Feb 15;71(4):743-50. PMID: 15742913.
  9. Gale C P, Camm A J. Assessment of palpitations. BMJ 2016; 352 :h5649 doi:10.1136/bmj.h5649

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