Palpitations : triage

Palpitations represent a subjective and often distressing sensation where individuals become acutely aware of their heartbeat, which may be experienced as an abnormal, rapid, fluttering, skipping, or pounding feeling in the chest or neck. This condition is not only a common presentation in general practice but also one of the primary reasons for referrals to cardiologists. While palpitations can arise from a variety of sources, including both cardiac and non-cardiac causes, or even as a manifestation of a high catecholamine state, they invariably lead to increased patient anxiety and concern.

Despite often being benign and without a significant underlying health issue, the experience of palpitations can significantly impact an individual's quality of life, contributing to ongoing worry and long-term morbidity. The high frequency of palpitations within the general population underscores the importance of a thorough evaluation to determine their cause, manage potential risks, and address the considerable distress they can cause to those affected.

Table: triage for palpitations, focusing on key history elements to determine during evaluation: