Abstract:
Palpitations are a common, non-specific presenting complaint in primary healthcare and
emergency departments. Palpitations are mostly a symptom of benign underlying disease but
a sign of life-threatening conditions. Importantly, palpitations are a symptom and not a
diagnosis, and cardiac causes are the most concerning aetiology. Clinicians should seek to
identify the underlying cause. History and physical examination are important in the
assessment of patients with palpitations, and the use of a 12-lead electrographic (ECG) monitor
on presentation is the gold standard of diagnosis. If the aetiology cannot be determined, an
ambulatory Holter 24–48-h monitor can be used. Treatment and follow-up of patients
presenting with palpitations as the main complaint will depend on the aetiology and
investigation findings. Patients with palpitations accompanied by dizziness, excessive fatigue,
or chest pains should receive adequate acute care aiming to stabilise their condition before
referring to a higher level of care.
