This study states Palpitations are used to describe subjective, perceived heartbeats that cause feelings of heart racing, irregularity and heart pounding. They are the second most common cardiac presentation to primary care that requires cardiac investigation. These are distressing symptoms for patients but, for the majority, not a manifestation of a significant underlying disease. Occasionally palpitations can be a clinical manifestation of serious underlying causes, including atrial fibrillation, supraventricular tachycardia and ventricular arrhythmias. Studies have found a high incidence of anxiety disorder in patients presenting with palpitations. This may impact the clinician decision to refer to a specialist cardiology clinic as simple reassurance may have limited effectiveness in addressing the anxiety (9). Palpitations, therefore, embody a management challenge for primary care physicians; the fear of missing more sinister conditions can lead them to refer patients who may otherwise be managed in primary care. Patients can be risk stratified by their clinical history, examination and routine investigations available to many primary care services, such as an electrocardiogram (ECG) or blood tests.


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