The aetiological profile of new onset palpitations in natives of Western Himalayas: a cross sectional observational study

Manish Kumar Thakur, Rajesh Kashyap, Rajeev Marwaha, Ravi C. Sharma, Dalip Gupta, Sunil Sharma, Jai Bharat Sharma


Background: Palpitation is a common presenting complaint in out patient department. Etiological profile of such patients has not been studied in the recent past. The aim of the study was to study the aetiological profile of patients with new onset palpitations in North Indian tertiary health care centre.

Methods: 130 consecutive patients of new onset palpitations were enrolled in the study and the aetiological profile of palpitation was evaluated using detailed history, examination and investigations.

Results: The study group had 53% female and 47% male with a ratio of 1.13:1. Majority of the patients in the age group of 18-29 years. The mean age was 32.04+15.14 years. Most common symptom associated was shortness of breath seen in 17% patients. Of the 130 patients 43.8% of patients had cardiac aetiology, 35.38% psychiatric and 20% had miscellaneous aetiology. Among cardiac aetiology, arrhythmias were most common. PSVT was encountered in 15.4% and AF in 13.1%of the total patients. Psychiatry causes were observed in 35% of patients. In psychiatric causes 71.7% patients had panic attack whereas 28.2% patients had generalised anxiety disorder (GAD). In third group of miscellaneous causes which was 20% of total 6.9% had anaemia, 10% hyperthyroidism and 3.8% were on beta agonists.

Conclusions: Palpitation is a presenting symptom of various diseases. The cause can be easily ascertained in most of the patients by a good history and examination; serious cardiac diseases require special investigation. Palpitation as a symptom should not be overlooked the underlying cause must be identified; this can be a helpful clue to improve patient outcome.


Anaemia, Arrythmia, Palpitations, Panic attack

Full Text:



Dorland Medical Dictionary 29th ed. : 621.

Kroenke K, Arrington ME, Mangelsdroff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med 1990; 150: 1685–9..

Barsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. Psychiatric disorders in medical outpatients complaining of palpitations. J Gen Intern Med 1994; 9:306–13.

Weber BE, Kapoor WH. Evaluations and outcomes of patients with palpitations. Am J Med 1996; 100:138–48.

Summerton N, Mann S, Rigby A, Petkar S, Dhawan J. New-onset palpitations in general practice: assessing the discriminant value of items within the clinical history. Fam Pract 2001; 18:383–92.

Porter MJ, Morton JB, Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm.2004:393-6.

Jonsbu E. Patients With No cardiac Chest Pain and Benign Palpitations Referred for Cardiac Outpatient Investigation: A 6-Month Follow-Up. Gen Hosp Psychiatry 2010; 406-412.

Barsky AJ, Cleary PD, Sarnie MK. Panic disorder, palpitations and awareness of cardiac activity. J Nerv Ment Dis 1994; 182:63–71.

Chignon JM, Lepine JP, Ades J. Panic disorder in cardiac outpatients. Am J Psychiatry 1993; 150:780–5.

Ahern DK, Delameter BA, Clancy SA, Bailey ED. Differential diagnosis of palpitations. Preliminary development of a screening instrument. Arch Fam Med 1997; 6:241–5.