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Approach to the child with palpitations

Robert Mazor, MD
Suzan Mazor, MD
Section Editors
George A Woodward, MD
Jan E Drutz, MD
Deputy Editor
James F Wiley, II, MD, MPH


This topic will review the differential diagnosis and approach to the child with palpitations.

The differential diagnosis of tachycardia in children who do not have palpitations is discussed elsewhere. (See "Approach to the child with tachycardia".)


Palpitations describe a noticeable heartbeat that may be concerning to the patient (eg, too fast, irregular, or too strong). In adults, palpitations occasionally herald serious underlying cardiac events [1]. However, palpitations in children typically arise from physiologic stimuli, such as fever, exercise, anxiety, or anemia, rather than life-threatening causes (eg, cardiac arrhythmia). In addition, children with serious arrhythmias may report no palpitations.


The differential diagnosis of palpitations encompasses rare etiologies that are life-threatening and common causes (algorithm 1 and table 1).

Life-threatening causes — Children with a serious underlying cause for their palpitations often have a history of syncope, congenital heart disease, or cardiac surgery (table 1) [2-6].

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Literature review current through: Nov 2017. | This topic last updated: Aug 01, 2017.
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