Evidence-Based Approach to Palpitations

Med Clin North Am. 2021 Jan;105(1):93-106. doi: 10.1016/j.mcna.2020.09.004.


Palpitations are a common presenting symptom in primary care, yet their cause can be difficult to diagnose due to their intermittent and sometimes infrequent nature. All patients presenting with a chief complaint of palpitations should undergo a detailed history, physical examination, and electrocardiogram (ECG). This alone can yield a probable diagnosis. Limited laboratory testing, ambulatory ECG monitoring, and cardiology referral are sometimes indicated. This article reviews current data and guidelines on how to evaluate palpitations in the primary care setting.

Keywords: Ambulatory ECG; Diagnose; Heart monitor; Palpitations; Primary care; Workup.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / economics
  • Arrhythmias, Cardiac / etiology*
  • Diagnosis, Differential
  • Electrocardiography
  • Electrocardiography, Ambulatory
  • Evidence-Based Medicine
  • Health Care Costs
  • Humans
  • Medical History Taking
  • Physical Examination
  • Primary Health Care