General Approach to a History of Palpitations

General Questions About Palpitations

 NOTE: Confirm Palpitations - unpleasant awareness of the forceful, rapid, or irregular beating of the heart

Differentials for Palpitations

 CVS
 Metabolic
 High Output States
 Medications
 Psychiatric
 Catecholamine excess

System Subset Question

CVS Any arrhythmia Have you ever felt irregular heart beats?
Please clap out the rhythm.
Valvular heart Prior dx
disease Childhood infection
IVDA
Other cardiac Cardiomyopathy
causes
Metabolic Hypoglycaemia Do you often get hungry?
Cold sweats?
How is your appetite? Do you skip meals?
Any new medications?
Any fever, nausea, vomiting?
(Phx: DM)
Thyrotoxicosis Tremors
Irritability
Heat intolerance
Insomnia
Pheochromocytoma
High Output Anaemia Giddiness, lethargy
States Pregnancy
Fever