Problem based review: the patient with 'palpitations'.

Palpitations, or the sensation of a rapid or heavy heartbeat, are a common symptom in both primary and secondary care settings. Here we use a common presentation of palpitations to explore the best ways to assess and treat patients who present in this way. We hope that by using a structured approach to our assessment we will reduce the use of the 'scattergun' approach to diagnosis, thus preventing unnecessary investigation and hospital stay.