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 rapid and irregular heart rhythms. It can cause palpitations, shortness of breath, and fatigue.
- Premature Atrial Contractions (PACs) or Premature Ventricular Contractions (PVCs): These are extra heartbeats that can feel like 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 (slow heart rate), while hyperthyroidism can cause tachycardia (fast heart rate).
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, palpitations can be a symptom of a heart attack, especially in individuals with risk factors such as high blood pressure, diabetes, or a family history of heart disease.
- Cardiac Tamponade: A serious medical condition where fluid accumulates in the sac around the heart, leading to palpitations, shortness of breath, and potentially fatal outcomes if not treated promptly.
- Pulmonary Embolism: A blockage of an artery in the lungs that can cause palpitations, chest pain, and shortness of breath, requiring immediate medical attention.
- Hypertrophic Cardiomyopathy: A condition where the heart muscle becomes thick, 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 and palpitations.
- Long QT Syndrome: A rare disorder of the heart's electrical activity that can cause sudden, uncontrollable, dangerous arrhythmias, often triggered by palpitations.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of palpitations, hypertension, and sweating due to the excessive release of catecholamines.