{"id":289,"date":"2017-03-26T12:33:39","date_gmt":"2017-03-26T12:33:39","guid":{"rendered":"http:\/\/papergp.com\/index.php\/cardiovascular\/palpitations\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"palpitations","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/cardiovascular\/palpitations\/","title":{"rendered":"Palpitations"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>Chest pain, Breathless, Lightheaded, Clammy, LOC, Exertional<\/li>\n<li>PMH: pre-existing heart disease<\/li>\n<li>FH: sudden cardiac death<\/li>\n<li>Abnormal resting ECG<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>Caffeine, anxiety<\/li>\n<li>Frequency<\/li>\n<li>Triggers<\/li>\n<li>SH: alcohol, smoking<\/li>\n<li>Non-cardiac causes\n<ul>\n<li>Thyrotoxicosis<\/li>\n<li>Anaemia<\/li>\n<li>Sepsis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Examine\n<ul>\n<li>BP, pulse<\/li>\n<li>Signs of anaemia<\/li>\n<li>CV examination<\/li>\n<li>Thyroid examination<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods\n<ul>\n<li>FBC, U+E, LFTs, TFTs, HbA1c, cholesterol<\/li>\n<\/ul>\n<\/li>\n<li>ECG<\/li>\n<li>Echo\n<ul>\n<li>If murmur, suspected heart failure or structural heart disease (LBBB, LVH, Q-waves)<\/li>\n<\/ul>\n<\/li>\n<li>24hr ECG<\/li>\n<li>Event recorder (if infrequent symptoms)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>The term &#8216;palpitations&#8217; is used when we are aware of our heart beating. Common causes: caffeine, smoking, overactive thyroid, anxiety, irregular heart rhythms.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Ectopics\n<ul>\n<li>&lt;5% but otherwise normal ECG and no structural heart disease\n<ul>\n<li>Reassure, reduce stress\/caffeine\/alcohol\/smoking\/drugs<\/li>\n<li>consider beta-blocker<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>DVLA\n<ul>\n<li>If syncope or cardiac cause<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Follow-up \/ Safety net\n<ul>\n<li>Refer\n<ul>\n<li>SVT<\/li>\n<li>Atrial flutter, atrial tachycardia<\/li>\n<li>Ventricular tachycardia<\/li>\n<li>Ectopics with abnormal ECG or evidence of structural heart disease<\/li>\n<li>Red flags (unless unstable in which case, admit)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Source<\/h4>\n<p><a href=\"https:\/\/gps.camdenccg.nhs.uk\/cdn\/serve\/pathway-downloads\/1513934127-8450efe46f9b392d7e859287e854cd7d.pdf\">Camden CCG Adult Palpitations Pathway<\/a>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering Red flags Chest pain, Breathless, Lightheaded, Clammy, LOC, Exertional PMH: pre-existing heart disease FH: sudden cardiac death Abnormal resting ECG Others Caffeine, anxiety Frequency Triggers SH: alcohol, smoking Non-cardiac causes Thyrotoxicosis Anaemia Sepsis Examine BP, pulse Signs of anaemia CV examination Thyroid examination &nbsp; Clinical management Investigations Bloods FBC, U+E, LFTs, TFTs, HbA1c, &hellip; <a href=\"https:\/\/papergp.com\/index.php\/cardiovascular\/palpitations\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Palpitations<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":284,"menu_order":48,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-289","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/289","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=289"}],"version-history":[{"count":8,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/289\/revisions"}],"predecessor-version":[{"id":2113,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/289\/revisions\/2113"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/284"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}