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Palpitations - Coggle Diagram
Palpitations
Atrial Fibrillation of Flutter
https://rightdecisions.scot.nhs.uk/m/cezdl5ze/135-atrial-fibrillation-24.pdf
12 Lead ECG
U&E's, FBC, TFT's & LFT's
Echo
CHADSVASC score
https://www.mdcalc.com/calc/801/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk
Score 0 - No Anti-thrombotic
Score 1 - Consider DOAC
Score >1 - Prescribe DOAC
Rate Control
Target <110bpm or <80bpm if still symptomatic
Without HF
Beta-Blocker OR Rate limiting CCB
With HF
Digoxin OR Beta-Blocker
Lifestyle
Weight loss if BMI >27
Physical activity
Reduce / avoid alcohol
Emergency admission if current palpitations and:
Ventricular Tachycardia (VT)
Persistent SVT
Breathlessness, syncope, chest pain
Hypotension
Abnormally perceived heartbeat
Racing
Irregularity
Pounding
Unclear cause
Ambulatory monitoring
Echo
Refer to cardiology if recurrent
Ectopic beats
Tachycardia
ECG - Record ECG whilst symptomatic if possible - Gold standard
Clinical history - Breathlessness? Chest Pain? Syncope?
Check history of IHD, heart failure, cardiomyopathy, or valve disease
Family Hx - SCD
Clinical cardio-respiratory exam
https://cks.nice.org.uk/topics/palpitations/