Key result
History, physical exam, and ECG remain the primary diagnostic approach for palpitations in primary care.
Why the study?
Palpitations are common in primary care and usually benign, but can represent potentially fatal conditions or coexist with psychiatric comorbidities.
A systematic clinical approach including history, physical examination, and 12-lead ECG is essential for evaluating palpitations, with ambulatory monitoring reserved for suspected arrhythmias or structural heart disease.
May guide initial primary care palpitations assessment; leaves open optimal monitoring thresholds in low-risk patients.
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.
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Ribero-Vargas et al. (2025) conducted a review in Palpitations. A systematic clinical evaluation including history, physical examination, and a 12-lead ECG is the primary diagnostic approach for evaluating palpitations in primary care.
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