Emergency management of palpitations in the elderly: epidemiology, diagnostic approaches, and therapeutic options

Palpitations are a common complaint among elderly patients presenting to the emergency department. Although most are benign, the elderly do have a higher risk of having a cardiac cause. Other causes include psychiatric disorders, and sometimes a combination of cardiac and psychiatric causes coexist. A history and physical examination, including a detailed medication history, are an essential part of the workup in older patients. A 12-lead electrocardiogram is an essential first step toward a diagnosis; other tests are recommended in high-risk patients, including those with underlying coronary artery disease or structural cardiac abnormalities.