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Managing palpitations in the military patient
  1. Thomas Evans1,2,
  2. D A Holdsworth3,
  3. S Jackson4 and
  4. E Nicol5,6
  1. 1Medical Centre, British Army, Forres, Morayshire, UK
  2. 2Royal Centre for Defence Medicine, Defence Medical Services, Lichfield, UK
  3. 3Department of Physiology Anatomy and Genetics, Oxford University, Oxford, UK
  4. 4Army, Chilbolton, Hampshire, UK
  5. 5Department of Cardiovascular CT, Royal Brompton Hospital, London, UK
  6. 6Royal Centre for Defence Medicine, Defence Medical Services, Lichfield, UK
  1. Correspondence to Maj David A Holdsworth, Department of Physiology, Anatomy and Genetics, Sherrington Building, University of Oxford, Oxford OX1 3PT, UK; david.holdsworth{at}


‘Palpitations’ include a broad range of symptoms relating to the perception of abnormal activity of the heart. They may reflect an underlying arrhythmia or a hyperawareness of normal cardiac activity caused by stress or anxiety. The challenge to a clinician assessing patients with palpitations is to assess the likely cause of symptoms, to stratify the individual patient risk and to choose the correct management strategy delivered with appropriate urgency. The young military population, subject to increased exposure to environmental stress, is at an increased risk of palpitations. Due to the distracting nature of this symptom and the frequently sudden and unheralded onset, a common consequence is medical downgrading. This article will provide a guide to assessing the heterogeneous group presenting with palpitations and how to both establish the cause and identify the correct treatment for each patient in a timely manner.

  • Palpitations
  • Arrhythmia
  • Occupational cardiology

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