Thanks for contacting HCM with your health concern and following is symptomwise approach:
1.
Anxiety is the most commonest cause of palpitations and before that exclude Anemia( check
hemoglobin),
Hyperthyroidism,
Left ventricular hypertrophy (LVH), & Arrhythmias.
2. Palpate the pulse (during an attack) for
tachycardia & arrhythmias. If pulse rate is > 90/min, look for thyroid enlargement. Then. auscultate the heart for murmurs and look for heaving apex beat of LVH.
3. If no response to treatment is see then. check with
. serum T3, T4 and TSH
. ECG & Holter monitoring
. If diabetic, exclude low blood glucose
4. If pulse is normal, and heart is normal, then palpitations are due to anxiety and will respond to tranquilisers and beta blockers.
5. If palpitations are due to LVH, the forcecful beat is going to persist and he should learn to accept it.
6. Avoid excess tea & coffee
. avoid alcohol & smoking
. avoid mental strain.