Differential Diagnosis for Palpitations
- Single most likely diagnosis
- Anxiety or Stress: Palpitations are a common symptom of anxiety and stress, often accompanied by other symptoms such as shortness of breath, tremors, and chest discomfort. The high prevalence of anxiety disorders and the frequent occurrence of stress in daily life make this a likely cause.
- Other Likely diagnoses
- Atrial Fibrillation: A common cardiac arrhythmia characterized by an irregular and often rapid heart rate, which can cause palpitations. Risk factors include age, hypertension, and heart disease.
- Premature Atrial Contractions (PACs) or Premature Ventricular Contractions (PVCs): These are extra heartbeats that can cause the sensation of palpitations. They are often benign but can be associated with underlying heart conditions or stimulant use.
- Mitral Valve Prolapse: A condition where the mitral valve does not close properly, which can lead to palpitations among other symptoms. It's relatively common and often asymptomatic.
- Hypothyroidism: Although less common than hyperthyroidism as a cause of palpitations, hypothyroidism can lead to cardiac symptoms due to its effects on the cardiovascular system.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Myocardial Infarction (MI) or Acute Coronary Syndrome: Although palpitations are not the most common presenting symptom, in some cases, especially in women or diabetic patients, MI can present atypically with palpitations.
- Pulmonary Embolism: A life-threatening condition that can cause palpitations among other symptoms like shortness of breath and chest pain.
- Cardiac Tamponade: A serious medical condition where fluid accumulates in the sac around the heart, leading to impaired heart function. Palpitations can be a symptom, along with shortness of breath and chest pain.
- Hyperthyroidism: Especially in the context of thyroid storm, which is a life-threatening condition requiring immediate medical attention.
- 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 potentially palpitations.
- Long QT Syndrome: A disorder of the heart's electrical activity that can cause sudden, uncontrollable, dangerous arrhythmias, often presenting with palpitations or syncope.
- Brugada Syndrome: A genetic disorder characterized by abnormal ECG findings and an increased risk of sudden cardiac death, which can present with palpitations.