Palpitations: A Practical Approach

Palpitations are a frequent symptom in primary care, with most cases explained by benign etiologies; however, they may represent the initial manifestation of potentially fatal conditions. Psychiatric comorbidities should not be underestimated, as they may coexist with cardiac causes. The diagnostic approach is primarily clinical, requiring a systematic evaluation of history, physical examination, and a 12-lead electrocardiogram (ECG). Ambulatory ECG monitoring is indicated when clinical evaluation suggests arrhythmia or in patients with structural heart disease.