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Quick guide
Diagnostic approach
- ABCDE approach
- Targeted cardiovascular examination
- 12-lead ECG
- CBC
- BMP
- Troponin
- Urine drug screen
- Glucose POCT
- TFTs
- Urine β-hCG in individuals who can become pregnant
- Serum digoxin level if on digoxin
- TTE if structural heart disease is suspected
- Stress testing if ischemic heart disease is suspected
Management checklist
- Manage immediately life-threatening causes of palpitations.
- Manage underlying cause.
- Consult cardiology for life-threatening or refractory arrhythmias.
Most cases of palpitations are benign and self-limited; reassurance and outpatient evaluation are usually appropriate.
Red flag features
- Tachycardia
- Bradycardia
- Hypotension
- AMS
- Signs of acute heart failure
- Syncope
- Chest pain
- Dyspnea
- Family history of sudden cardiac death
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