1)      Hypercholesterolemia

2)      Hypertension

3)      Diabetes

4)      Blackouts or near blackouts with palpitations

5)      Chest pain with palpitations

6)      Dyspnea in palpitations

7)      Past rheumatic fever

8)      Heart murmurs – aortic stenosis, aortic regurgitation, mitral stenosis

9)      Dizziness, anxiety, lightheadedness, chest pain, palpitations felt at the neck and chest both, dyspnea, syncope, psychological distress, polyuria (Supraventricular tachycardia, sudden onset, and offset, )

10)    Elderly, dizziness, bradycardia, tachycardia, alternating bradycardia and tachycardia, fatigue, dyspnea, confusion, chest pain (sick sinus syndrome)

11)    Exclude pulsatile tinnitus and carotid bruit presenting as palpitations

12)    Bradycardia – per se can cause palpitations as it may increase the stroke volume

13)    Palpitations with angina, diaphoresis, presyncope, syncope (underlying heart disease likely)

14)    Palpitations felt at the neck and chest (heart disease likely)

15)    Sensation of heart-stopping, irregular heartbeat, and fluttering (correlated with heart disease)

16)    Palpitations that are frequent, disabling, and symptomatic more urgent evaluation than those that are infrequent and asymptomatic

17)    Associated palpable abnormalitites in the pulse – atrial fibrillation, atrila flutter, bradyarrhythmias

18)    ECG signs – bifascicular heart block, QRS duration > 120 ms, second degree AV block, sinus bradycardia, prolonged QT interval, Q waves, arrhythmogenic right ventricular dysplasia (T inversion in V1-V3, QRS duration > 110 ms in V1-V3)

19)    ECG signs – Brugada pattern – ST elevation in V1-V3, coved appearance of elevated ST segment, T wave inversion, associated with increased risk of ventricular arrythmias, sudden cardiac death (Brugada syndrome), howevere this pattern may also occur in right ventricular infarction, hyperkalemia, drugs,