Palpitations in General Practice- Ventricular Ectopics

Send us Fan MailIn this episode, we dive into the clinical assessment and management of palpitations, one of the most common presentations in general practice. Palpitations account for roughly 16% of general practice visits and are the second most common presentation to cardiologists right after chest pain. While they are often benign, they can sometimes signal a life-threatening arrhythmia.A major focus of this episode is the danger of premature psychological diagnoses. Did you know that 54% of patients initially labeled as having anxiety or panic disorders are eventually diagnosed with an actual arrhythmic cause? We discuss why you shouldn't prematurely label a patient with anxiety and how to avoid the average 3.3-year delay to an accurate arrhythmia diagnosis.Join us as we break down the core history-taking skills, diagnostic tools, and referral pathways every clinician needs to know.In this episode, we cover:The Key Questions to Ask: How to clarify the subjective symptom of palpitations, including asking the patient to tap out the rhythm of an episode. We also explore how onset, offset, and duration clues can help distinguish between sinus tachycardia, supraventricular tachycardia (SVT), and atrial fibrillation.Spotting the Red Flags: Learn the critical warning signs that require immediate emergency transfer or early referral, including syncope, ongoing chest pain, and a family history of sudden cardiac death.Choosing the Right Investigations: A breakdown of when to use a standard 12-lead ECG, 24–48 hour Holter monitors, or implantable loop recorders based on the frequency of the patient's symptoms.Deep Dive into PVCs: We explain Premature Ventricular Complexes (PVCs), outlining why up to 100 per day is completely normal, what causes them, and when they actually predispose patients to malignant ventricular arrhythmias.Management & Safety Netting: Practical tips for patient care, including when to provide reassurance and how to teach patients with SVT simple vagal maneuvers like the Valsalva maneuver or applying a cold stimulus to the face.Support the show⚠️ Disclaimer: The voices in this podcast are AI-generated. This content is produced for entertainment and learning purposes only and does not constitute medical advice. Clinical decisions should always be made in accordance with current guidelines, individual patient circumstances, and in consultation with appropriate colleagues and specialists.