1)      Stress, fear, anxiety states – other symptoms suggestive of somatic anxiety syndrome seen, recent stress may be seen,

2)      Somatic anxiety syndrome – palpitations as a part of somatic anxiety syndrome

3)      Caffeine, nicotine, cocaine, diet pills -

4)      Anemia – fatigue, dyspnea on exertion, pallor, sweating, pica, limb swelling, evidence of CCF later in the course

5)      Sleep apnea syndrome (See under Medically Unexplained Symptoms)

6)      Suprventricular tachyacardia - Dizziness, anxiety, light headedness, chest pain, palpitations fetl at the neck and chest both, dyspnea, syncope, psychologic distress, polyuria, sudden onset and offset, the usual heart rates are in the range of 160-200 beats pr minutes as opposed to ventricular tachycardias the rate is 120-160 beats per minute, Mx – carotid sinus massage (N), referral for further management.

7)      Drug-induced – calcium channel blockers, sympathomimetics, sympathomimetic inhalers and nebulizer solutions

8)      Hyperthyroidism – see under medically unexplained symptoms

9)      Somatic depression syndrome

10)    Palpitations associated with a normal heart rate and rhythm practically exclude heart disease