Differential Diagnosis for Palpitations

Single Most Likely Diagnosis

• Anxiety or Stress-Related Palpitations: This is often the most common cause of palpitations, especially in individuals with a history of anxiety or stress. The physical symptoms of anxiety, such as increased heart rate and forceful heartbeat, can lead to the sensation of palpitations.

Other Likely Diagnoses

• Atrial Fibrillation: A common cardiac arrhythmia characterized by an irregular and often rapid heart rate, which can cause palpitations.
• Premature Atrial Contractions (PACs) or Premature Ventricular Contractions (PVCs): These are extra heartbeats that can cause the sensation of palpitations. They are usually benign but can be bothersome.
• Mitral Valve Prolapse: A condition where the two valve flaps of the mitral valve do not close smoothly or evenly, which can lead to palpitations among other symptoms.
• Hypothyroidism or Hyperthyroidism: Thyroid disorders can affect heart rate, leading to palpitations. Hypothyroidism can cause bradycardia, while hyperthyroidism can cause tachycardia.

Do Not Miss Diagnoses

• Myocardial Infarction (MI) or Acute Coronary Syndrome: Although less common, palpitations can be a symptom of a heart attack, especially in individuals with risk factors for coronary artery disease.
• Cardiac Tamponade: A life-threatening condition where fluid accumulates in the sac around the heart, compressing it and impeding its ability to fill with blood.
• Pulmonary Embolism: A blockage of an artery in the lungs that can cause sudden onset of palpitations among other severe symptoms.
• Hypertrophic Cardiomyopathy: A condition where the heart muscle becomes thickened, which can lead to arrhythmias and palpitations, and increases the risk of sudden cardiac death.

Rare Diagnoses

• Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare heart condition where the muscle in the right ventricle is replaced by fat and scar tissue, leading to arrhythmias.
• Long QT Syndrome: A disorder of the heart's electrical activity that can cause sudden, uncontrollable, dangerous arrhythmias.
• Brugada Syndrome: A genetic disorder characterized by abnormal electrocardiogram (ECG) findings and an increased risk of sudden cardiac death.
• Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of palpitations, hypertension, and other symptoms due to excessive catecholamine release.