CPD Articles

Palpitations: Evaluation and management by primary care practitioners

Indiran Govender, Kamelia K. Nashed, Selvandran Rangiah, Sunday Okeke, Olga M. Maphasha
South African Family Practice | Vol 64, No 1 : Part 1| a5449 | DOI: https://doi.org/10.4102/safp.v64i1.5449 | © 2022 Indiran Govender, Kamelia K. Nashed, Selvandran Rangiah, Sunday Okeke, Olga M. Maphasha | This work is licensed under CC Attribution 4.0
Submitted: 10 November 2021 | Published: 24 February 2022

About the author(s)

Indiran Govender, Department Family Medicine and Primary Health Care, Faculty Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Kamelia K. Nashed, Department Family Medicine and Primary Health Care, Faculty Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Selvandran Rangiah, Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Sunday Okeke, Department of Family Medicine, Faculty of Medicine, University of Pretoria, Pretoria, South Africa
Olga M. Maphasha, Department of Family Medicine, University of Pretoria and Kalafong Provincial Tertiary Hospital, Pretoria, South Africa

Abstract

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.


Keywords

palpitations; ECG; arrhythmia; chest pain; tachycardia

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