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Table 8.5

Systemic Factors Which May Trigger or Exacerbate Palpitation

Psychological factors (e.g. generalized anxiety disorder, panic disorder)

Sepsis

Hypovolaemia with postural hypotension

Postural orthostatic tachycardia syndrome

Anaemia

Pregnancy

Pulmonary embolism

Hypoglycaemia

Thyrotoxicosis

Phaeochromocytoma

Caffeine excess

Alcohol excess/alcohol withdrawal

Prescribed drugs (e.g. inhaled salbutamol, nifedipine, drugs with anticholinergic effect; see http://www.sads.org.uk/drugs-to-avoid/)

Recreational drugs (e.g. cannabis, cocaine, amphetamine)

Electrolyte derangement (hypo- or hyperkalaemia, hypo- or hypercalcaemia, hypomagnesaemia)