What are the diagnostic methods for palpitations?

The initial evaluation of palpitations should begin with an electrocardiogram (ECG), including both standard 12-lead ECG and ambulatory (Holter) ECG monitoring, as well as a comprehensive transthoracic echocardiogram to assess cardiac structure and function. It is essential not only to identify cardiac causes of palpitations but also to evaluate potential non-cardiac etiologies involving other organ systems. Notably, thyroid dysfunction is a common contributor; therefore, thyroid function tests (TFTs) and thyroid ultrasonography should be performed. Secondly, anemia must be considered. Patients suspected of anemia should undergo complete blood count (CBC) testing to determine hemoglobin levels. Palpitations associated with obesity or sleep disorders often reflect psychophysiologic (psychological) origins. After excluding organic disease, clinicians should assess for underlying psychological conditions—particularly those manifesting as panic symptoms.