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Palpitations are common. The challenge is determining when the sensation represents a dangerous rhythm or underlying disease.

In Episode 2 of The Clinical Next Step, we approach palpitations using practical Canadian clinical reasoning for MCCQE preparation.

This episode focuses on the decisions that matter: assessing clinical stability, characterizing the patient's symptoms, recognizing important arrhythmias and underlying causes, selecting the appropriate cardiac investigation or monitoring strategy, and identifying patients who require urgent intervention.

Topics covered include:

• Initial assessment and recognition of instability • Characterizing palpitations by onset, duration and associated symptoms • Cardiac and non-cardiac causes • Tachyarrhythmias and bradyarrhythmias • ECG interpretation in the clinical context • Choosing Holter, event and longer-term rhythm monitoring • Laboratory and targeted investigations • Syncope, chest pain and other important red flags • Immediate management of unstable arrhythmias • Common MCCQE clinical-reasoning traps • Disposition, follow-up and patient counselling

Recognize the pattern. Find the danger. Choose the next step.

The Clinical Next Step is an independent educational podcast. It is not affiliated with or endorsed by the Medical Council of Canada (MCC). Content is provided for medical education and does not replace current clinical guidelines, institutional protocols, or professional medical judgment.