Open AccessPalpitations: Evaluation and management by primary care practitioners
Author(s) -
Indiran Govender,
Kamelia Kamel Nashed,
Selvandran Rangiah,
Sunday Okwudili Okeke,
Olga Maphasha
Publication year - 2022
Publication title -
south african family practice
Language(s) - English
Resource type - Journals
eISSN - 2078-6204
pISSN - 2078-6190
DOI - 10.4102/safp.v64i1.5449
Subject(s) - palpitations , medicine , etiology , emergency department , physical examination , primary care physician , complaint , intensive care medicine , disease , medical emergency , pediatrics , primary care , psychiatry , family medicine , political science , law
Palpitations are a common, non-specific presenting complaint in primary healthcare and emergency departments. Palpitations are mostly a symptom of benign underlying disease but a sign of life-threatening conditions. Importantly, palpitations are a symptom and not a diagnosis, and cardiac causes are the most concerning aetiology. Clinicians should seek to identify the underlying cause. History and physical examination are important in the assessment of patients with palpitations, and the use of a 12-lead electrographic (ECG) monitor on presentation is the gold standard of diagnosis. If the aetiology cannot be determined, an ambulatory Holter 24–48-h monitor can be used. Treatment and follow-up of patients presenting with palpitations as the main complaint will depend on the aetiology and investigation findings. Patients with palpitations accompanied by dizziness, excessive fatigue, or chest pains should receive adequate acute care aiming to stabilise their condition before referring to a higher level of care.