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Last updated: October 23, 2025View editorial policy

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Differential Diagnosis for Heart Palpitations

Single Most Likely Diagnosis

  • Anxiety or Stress: Heart palpitations are a common symptom of anxiety and stress, which can cause an increase in heart rate and forceful heartbeats, leading to the sensation of palpitations.

Other Likely Diagnoses

  • Atrial Fibrillation: A type of irregular heartbeat that can cause palpitations, shortness of breath, and fatigue.
  • Mitral Valve Prolapse: A condition where the mitral valve does not close properly, leading to palpitations, chest pain, and shortness of breath.
  • Hyperthyroidism: An overactive thyroid gland can cause an increase in heart rate, leading to palpitations, weight loss, and heat intolerance.
  • Dehydration or Electrolyte Imbalance: Dehydration or an imbalance of essential electrolytes such as potassium, sodium, or magnesium can disrupt heart function, leading to palpitations.

Do Not Miss Diagnoses

  • Myocardial Infarction (Heart Attack): Although less common, heart palpitations can be a symptom of a heart attack, especially in individuals with a history of heart disease.
  • Cardiac Tamponade: A life-threatening condition where fluid accumulates in the sac surrounding the heart, leading to palpitations, chest pain, and shortness of breath.
  • Pulmonary Embolism: A blood clot in the lungs can cause palpitations, chest pain, and shortness of breath, and is a medical emergency.
  • Hypertrophic Cardiomyopathy: A condition where the heart muscle becomes thickened, leading to palpitations, chest pain, and shortness of breath, and can increase the risk of sudden cardiac death.

Rare Diagnoses

  • Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare condition where the heart muscle in the right ventricle is replaced by fatty tissue, leading to palpitations, chest pain, and shortness of breath.
  • Long QT Syndrome: A rare genetic disorder that affects the heart's electrical system, leading to palpitations, fainting, and sudden cardiac death.
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause an increase in heart rate and blood pressure, leading to palpitations, headaches, and sweating.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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