{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:43:35Z","timestamp":1792395815755,"version":"4.4.0"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126124494_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Palpitations are not an uncommon complaint in the paediatric emergency department, causing significant anxiety for families concerned about serious heart disease. However, most cases are benign, often stemming from normal physiological responses like fever or anxiety. Primary cardiac arrhythmias are rare in this clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124494_as2\">\n                    <jats:title>Problem:<\/jats:title>\n                    <jats:p>The main challenge is identifying the few children with dangerous arrhythmias among the many benign cases. Fear of missing a life-threatening condition often leads to extensive, costly, and stressful investigations, even in low-risk patients, without significantly improving detection rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124494_as3\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This review aims to create a structured, risk-based framework for evaluating paediatric palpitations in the emergency department. The goal is to help clinicians efficiently distinguish benign from potentially life-threatening causes, thereby optimising resource use and reducing family anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124494_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>A thorough clinical history, physical exam, and a standard 12-lead electrocardiogram are the most effective evaluation tools. \u201cRed-flag\u201d features\u2014such as palpitations with fainting (syncope), onset during exercise, or a family history of sudden cardiac death\u2014successfully identify nearly all children with significant arrhythmias. Barring certain risk factors and any abnormalities on a 12 lead electrocardiogram, a dangerous cardiac condition is highly unlikely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124494_as5\">\n                    <jats:title>Recommendations:<\/jats:title>\n                    <jats:p>A stratified approach is recommended. Low-risk children (no red-flag features, normal electrocardiogram) can be safely discharged with reassurance. High-risk patients require immediate, aggressive evaluation, including cardiology consultation and potential hospital admission. This strategy improves accuracy, is cost-effective, and enhances patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126124494","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:14:36Z","timestamp":1792394076000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Palpitations in children and adolescents in the emergency department: a state-of-the-art narrative review of arrhythmia risk, diagnostic strategy, and disposition"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3919-9873","authenticated-orcid":false,"given":"Khaled","family":"Abouelmagd","sequence":"first","affiliation":[{"name":"Al-Azhar University Damietta Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temitomi Jane","family":"Oyedele","sequence":"additional","affiliation":[{"name":"Bowen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Berger","sequence":"additional","affiliation":[{"name":"St. George\u2019s University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Fakhiraldeen","sequence":"additional","affiliation":[{"name":"University of Baghdad"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habiba","family":"Mohamed Ahmed ElMitwalli Ali","sequence":"additional","affiliation":[{"name":"Batterjee Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouran","family":"Hishmat","sequence":"additional","affiliation":[{"name":"May University in Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atiqullah","family":"Sadaqat","sequence":"additional","affiliation":[{"name":"Kateb University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren 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