Abstract
Background: Palpitations are common in adolescents and often occur without structural heart disease. Although anxiety and autonomic dysregulation have been implicated, the role of micronutrient status remains unclear. This study aimed to investigate the association between palpitations, micronutrient levels, and anxiety in adolescents and to evaluate the independent associations between selected micronutrients and palpitations using multivariable regression models. Methods: This case-control study included 52 adolescents with palpitations and 52 frequency-matched healthy controls. Structural heart disease was excluded by electrocardiography, echocardiography, and 24-h Holter monitoring. Results: Adolescents with palpitations had significantly lower serum magnesium, selenium, and ferritin levels and higher anxiety scores than controls, despite most values remaining within reference ranges. In age- and sex-adjusted analyses, lower magnesium and selenium levels were independently associated with palpitations. Conclusions: Subclinical differences in micronutrient status, particularly magnesium and selenium, together with increased anxiety, may contribute to non-structural palpitations in adolescents. These findings support a more integrative evaluation that includes micronutrient and psychological assessment alongside standard cardiac investigations.