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Diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

history and examination
ECG - occasionally may demonstrate evidence of pre-excitation or QT prolongation, ventricular hypertrophy or previously myocardial infarction
if diagnosis is not evident from the history and examination and 12-lead ECG
- the intensity and duration of subsequent investigations should be guided by the likelihood of the arrhythmia being significant
- other possible investigations include:
  - thyroid function tests, full blood count } together with a 12-lead ECG, these are often baseline tests when assessing a patient with palpitations in primary care
  - echocardiogram to detect structural heart disease
  - exercise testing when the problem is related to exercise
  - ambulatory ECG - the aim to is to obtain an ECG trace whilst the arrhythmia is occurring e.g. use of a 24-hour ECG tape. It is important to match the patients symptoms to particular rhythm disturbances on the ECG tape. This is because brief arrhythmias are a fairly common finding even in asymptomatic patients

Reference:

British Heart Foundation (Factfile 4/2004). Palpitations: their significance and investigation.

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