The DOI matches its Crossref record; 21 of the 23 references it cites were found in a registry or an index.
Evaluation of Patients with Palpitations
Abstract
Palpitations are one of the most common problems of outpatients who present to internists and cardiologists. Although usually benign, they are occasionally a manifestation of potentially life-threatening conditions. The physician's fear of missing a treatable condition may lead to the inappropriate use of expensive tests with little diagnostic and therapeutic value. The following discussion will describe the common presentations of palpitations and offer a guide to rational diagnostic testing.Common Presentations: Symptoms and Associated CircumstancesSymptomsPalpitations are described in a myriad of ways, but some specific symptoms are common and useful for narrowing the differential diagnosis.Flip-Flopping in the . . .
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In the citing paper
“Indeed, in many cases a definitive, or at least probable, diagnosis of the cause of palpitations is not reached and no specific therapy is initiated.5,6”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“From the aetiological point of view, the causes of palpitations can be subdivided into five main groups (Table 1): cardiac arrhythmias, structural heart diseases, psychosomatic disorders, systemic diseases, and effects of medical and recreational drugs.3 -9”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“It must be borne in mind, however, that cardiac arrhythmias and psychosomatic disorders are not mutually exclusive.5,24”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“It should, however, be stressed that patients are not always able to describe the characteristics of their symptoms precisely.It may therefore be difficult to identify the type of palpitation accurately, especially in the case of normalrate palpitations.5,9,61”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“The most common descriptions, and those most useful in clinical practice in differential diagnoses among the various causes of palpitations, enable palpitations to be classified according to the rate, rhythm, and intensity of heartbeat 5 -9,59,60 : extrasystolic palpitations, tachycardiac palpitations, anxiety-related palpitations, and pulsation palpitations (Table 2).”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“Certain symptoms and circumstances associated to palpitations are often connected with the various causes of the palpitations and may be very helpful in making differential diagnoses.5 -9,59,60”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
In the citing paper
“a substantial percentage (6-35%) of the arrhythmias diagnosed prove to be clinically significant, such as supraventricular tachycardias and atrial fibrillation.5”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [5]
Citations
Cites
Long-Term Follow-up of Asymptomatic Healthy Subjects with Frequent and Complex Ventricular Ectopy
Kennedy, H. L., Whitlock, J. A., Sprague, M. K., Kennedy, L. J., Buckingham, T. A., & Goldberg, R. J. (1985) · New England Journal of Medicine · doi:10.1056/nejm198501243120401 · Cited by 628
Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: A prospective study
Düren, D. R., Becker, A. E., & Dunning, A. J. (1988) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(88)90164-7 · Cited by 272
Kinlay, S., Leitch, J. W., Neil, A., Chapman, B. L., Hardy, D. B., & Fletcher, P. J. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-124-1_part_1-199601010-00003 · Cited by 245
Wolfe, C. L. P., Sievers, R. E., Visseren, F. L. J., & Donnelly, T. J. (1993) · Circulation · doi:10.1161/01.cir.87.3.881 · Cited by 196
Evaluation and outcomes of patients with palpitations
Weber, B. E., & Kapoor, W. N. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)89451-x · Cited by 196
Mechanism of ”inappropriate” sinus tachycardia. Role of sympathovagal balance
Morillo, C. A., Klein, G. J., Thakur, R. K., Li, H., Zardini, M., & Yee, R. (1994) · Circulation · doi:10.1161/01.cir.90.2.873 · Cited by 193
Leitch, J. W., Klein, G. J., Yee, R., Leather, R. A., & Kim, Y. H. (1992) · Circulation · doi:10.1161/01.cir.85.3.1064 · Cited by 171
Unrecognized Paroxysmal Supraventricular Tachycardia: Potential for Misdiagnosis as Panic Disorder
Lessmeier, T. J. (1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440260085013 · Cited by 157
Panic Disorder, Palpitations, and the Awareness of Cardiac Activity
BARSKY, A. J., CLEARY, P. D., SARNIE, M. K., & RUSKIN, J. N. (1994) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199402000-00001 · Cited by 135
Schwartz, P. J., & Priori, S. G. (1998) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.1998.tb00031.x · Cited by 128
Inappropriate Sinus Tachycardia: Evaluation and Therapy
KRAHN, A. D., YEE, R., KLEIN, G. J., & MORILLO, C. (1995) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1995.tb00391.x · Cited by 110
Differential Diagnosis of Supraventricular Tachycardia
Josephson, M. E., & Wellens, H. J. J. (1990) · Cardiology Clinics · doi:10.1016/s0733-8651(18)30348-5 · Cited by 106
Self-citationWolfe, R., Driscoll, D. J. O., Gersony, W. M., Hayes, C. J., Keane, J. F., Kidd, L., O’Fallon, W. M., Pieroni, D. R., & Weidman, W. H. (1993) · PubMed · Cited by 96
The hemodynamic effects of induced supraventricular tachycardia in man.
Goldreyer, B. N., Kastor, J. A., & Kershbaum, K. L. (1976) · Circulation · doi:10.1161/01.cir.54.5.783 · Cited by 91
Utility and cost of event recorders in the diagnosis of palpitations, presyncope, and syncope
Fogel, R. I., Evans, J. J., & Prystowsky, E. N. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00717-5 · Cited by 83
Utility of Patient-Activated Cardiac Event Recorders in General Clinical Practice
Zimetbaum, P., Kim, K. Y., Ho, K. K. L., Zebede, J., Josephson, M. E., & Goldberger, A. L. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00766-7 · Cited by 77
Self-citationPsychiatric disorders in medical outpatients complaining of palpitations
Barsky, A. J., Cleary, P. D., Coeytaux, R. R., & Ruskin, J. N. (1994) · Journal of General Internal Medicine · doi:10.1007/bf02599176 · Cited by 73
Brugada, P., Andries, E., Gürsoy, S., & Brugada, J. (1993) · The Lancet · doi:10.1016/0140-6736(93)91155-f · Cited by 71
Clinical approach to paroxysmal atrial fibrillation
Coumel, P. (1990) · Clinical Cardiology · doi:10.1002/clc.4960130311 · Cited by 66
The clinical course of palpitations in medical outpatients
Barsky, A. J. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430160124012 · Cited by 61
Therapy of “Idiopathic” Ventricular Tachycardia
Miller, J. M., Varma, N., & Josephson, M. E. (1997) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1997.tb00615.x · Cited by 53
Self-citation
Research works printed but not linked: 3
- 10.1001/archinte.155.16.1782 · DOI · Paper page
- 10.1001/archinte.157.5.537 · DOI · Paper page
- 1995, Circulation, 92, 673
Cited by
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Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Myerburg, R. J., Quiñones, M. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.010 · Cited by 1,975
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.054 · Cited by 1,902
Physical Activity and Mental Health: Current Concepts
Paluska, S. A., & Schwenk, T. L. (2000) · Sports Medicine · doi:10.2165/00007256-200029030-00003 · Cited by 1,722
Brugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomström‐Lundqvist, C., Calkins, H. G., Corrado, D., Deftereos, S. G., Diller, G., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz467 · Cited by 1,312
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.178233 · Cited by 1,080
Metadata
- Authors
- Zimetbaum, P., & Josephson, M. E.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- ORCID
- Zimetbaum, Peter
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1998-05-07
- Volume
- 338
- Issue
- 19
- Pages
- 1369-1373
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2007450066
- Cited by
- 172
- References
- 23
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 8 · 2019: 8 · 2018: 7 · 2017: 11 · 2016: 8 · 2015: 10 · 2014: 7 · 2013: 7 · 2012: 7
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- palpitations, differential diagnosis, diagnostic testing, unnecessary testing, cardiac arrhythmias, presenting symptoms
- MeSH terms
- Anxiety Disorders, Arrhythmias, Cardiac, Catecholamines, Electrocardiography, Humans, Posture, Exercise, Electrocardiography, Ambulatory, Panic Disorder
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