Palpitations, the abnormal perception of a heart beating, are a common cause for presentation to a GP and have a prevalence of up to 16% in primary care consultations. They are associated with long-term morbidity with a substantial proportion of patients reporting concern and anxiety despite the exclusion of a significant underlying cause. Palpitations are the second most common reason for a GP to refer to specialist cardiology. The challenge for GPs is to be able to differentiate palpitations of a benign aetiology, from those related to a significant underlying arrhythmia that requires prompt investigation and referral. This article aims to highlight the factors involved in making an assessment and stratifying risk in patients presenting with palpitations in a primary care setting.
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