Palpitations

Harrogate and District NHS Foundation Trust

Definition/Description

None provided

Red Flag Symptoms

Refer to Cardiology if palpitations associated with:

  • Presyncope
  • Syncope
  • Exercising
  • Chest pains
  • Prev IHD
  • FHx of SCD
  • CM

Guidelines on Management

Daily symptoms?

  • Yes - 24 hour tape
  • No - longer monitor - 48 hour / 72 hour / 14 days

Reassure, reduce risk factors if:

  • Had palpitations during cardiac monitoring, but no significant arrythmias
    • Likely benign palpitations:
      • Sinus tachy
      • VEs/SVEs < 5% burden
      • Nocturnal brady
      • Nocturnal pauses
  • No palpitations during cardiac monitoring 
    • Reduce risk factors then reassess and repeat monitoring if still symptomatic and monitor did not coincide with palpitations

Reduce risk factors:

  • Alcohol
  • Caffeine and Tea
  • Energy drinks
  • Drugs (cocaine)
  • Stress
  • Check TFTs
  • Meds: Salbutamol

Advice

  • Exercise
  • Anxiety management
  • BB if stress related

Referral Criteria/Information

Refer to Cardiology if:

  • Had palpitations during cardiac monitoring
    AND
  • Has significant arrhythmias:
    • Flutter
    • Fibrillatio
    • SVT
    • NSVT
    • VT
    • diurnal brady/pauses > 3secs
    • Ectopic burden > 5%

Additional Resources & Reference

  • SCD: sudden cardiac death
  • CM: cardiomyopathy
  • IHD: ischaemic heart disease
  • TFT: thyroid function test
  • SVT: supraventricular tachycardia
  • NSVT: non-sustained ventricular tachycardia
  • VT: ventricular tachycardia.

Associated Policies

There are no associated policies.

Specialties

Cardiology North Yorkshire

Places covered by

  • north-yorkshire

Hospital Trusts

  • harrogate-and-district