Key result
Palpitations remain mostly benign but prompt anxiety misdiagnoses in ~67% of patients.
Why the study?
Palpitations are a common symptom with diverse causes, including benign extrasystoles and psychological factors, but distinguishing true palpitations from other sensations is challenging.
Palpitations are a common symptom that are mostly benign or psychological in origin, though they can occasionally indicate serious arrhythmias or be misdiagnosed as anxiety.
Supports initial reassurance after normal ECG; leaves open prospective validation of risk-stratification tools in primary care.
#### What you need to know Palpitations are a symptom characterised by awareness of the heartbeat, often described as a strong, skipping, fluttering, racing, pounding, thudding, or jumping sensation in the chest. Some patients describe a sensation of having to cough or their breath being taken away. However, patients occasionally mean something other than palpitations, such as chest discomfort, which may need a different line of investigation. Most palpitations are benign (being atrial, nodal, or ventricular extrasystoles1), and probably less than half of cases are due to heart rhythm abnormalities or arrhythmias. Anxiety is a common cause of palpitations; up to a third have psychological causes.2 Infrequently, however, they may be incapacitating and can lead to syncope or sudden cardiac death. Equally, a large proportion of patients with palpitations (67% in one study3) are diagnosed as having panic, stress, or anxiety when, instead, they have an …
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Gale et al. (2016) conducted a review in Palpitations. Palpitations are mostly benign, with up to a third having psychological causes, though a large proportion of patients (67% in one study) are misdiagnosed with anxiety.
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