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Palpitations

 

Refer to cardiology for:

·         Symptoms/investigations suggestive of sustained tachycardia e.g. AF/SVT /VT

·         High risk features in the history/ abnormal examination

·         Significant abnormality on ECG. 

 

Referral to cardiology may not be required for:

·         symptoms suggestive of an awareness of normal sinus rhythm

·         sinus tachycardias

·         ectopic beats

 

IF there are

·         no high risk features in  the history

·         normal examination

·         normal ECG. 

These patients may be managed in the community with the elimination of precipitating factors and reassurance. Beta blockers can be considered if highly symptomatic. 

 

Tests prior to Referral:

·         ECG, a 12 lead ECG must be attached to the referral

·         FBC, eGFR, Thyroid function

·         Electrolytes including calcium and magnesium if suspicious of arrhythmia

·         Consider of urinary catecholamines

·         Consider 24 hour tape in patients with frequent / preferably daily symptoms if suspicious of a sustained tachyarrhthmia. Please attach a good quality copy if a 24 hour tape has been performed.

 

If a 24 hour tape is not mentioned, it will be assumed that one has not been done and may be requested by the cardiology department prior to the referral.   

 

For patients with symptoms which are proven to be Atrial Fibrillation/flutter, see Atrial Fibrillation/Flutter