Tele-triage for Palpitations

Audience: adult

Palpitations are sensations of a fast, fluttering, or pounding heartbeat. They can be caused by many factors, such as stress, caffeine, medications, or heart conditions. Telemedicine can help assess palpitations by reviewing your symptoms, medical history, and risk factors. During a tele-visit, a healthcare provider can guide you on whether your palpitations are likely harmless or if you need urgent in-person evaluation. However, some symptoms require immediate emergency care. This guide helps you understand when tele-triage is appropriate, what to prepare for your tele-visit, and when to seek urgent medical attention. Remember, telemedicine is a helpful tool but not a replacement for emergency or in-person care when needed.

Red flags — go in person / ER

• Chest pain or pressure during palpitations — seek emergency care immediately.
• Fainting or near-fainting with palpitations — call emergency services right away.
• Severe shortness of breath or difficulty breathing accompanying palpitations — get urgent medical help.

What telemedicine can do

• Initial assessment of mild or occasional palpitations.
• Review of symptoms and medical history related to palpitations.
• Guidance on lifestyle changes and when to seek in-person care.
• Follow-up consultations for stable palpitations.

What telemedicine cannot do

• Emergency symptoms such as chest pain, fainting, or severe shortness of breath.
• Diagnosis requiring physical examination or urgent tests like ECG in emergency settings.
• Management of life-threatening arrhythmias or cardiac arrest.

What Are Palpitations?

Palpitations feel like your heart is beating too hard, fast, skipping beats, or fluttering. They can happen during activity or at rest. Many people experience palpitations occasionally, and they are often harmless. Causes include stress, caffeine, nicotine, medications, or hormonal changes. Sometimes, palpitations may signal a heart rhythm problem or other medical conditions that need attention.

When to Use Telemedicine for Palpitations

Telemedicine can be a good first step if you have palpitations without severe symptoms. A healthcare provider can ask about your symptoms, medical history, and risk factors. They may help identify triggers or suggest lifestyle changes. They can also decide if you need further tests or in-person care. Tele-triage is useful for ongoing monitoring or mild symptoms that do not worsen.

When to Seek Urgent In-Person Care

If you have palpitations along with chest pain, shortness of breath, fainting, dizziness, or severe weakness, seek emergency care immediately. These symptoms may indicate a serious heart problem. Also, if palpitations are new, very frequent, or worsening quickly, in-person evaluation is important. Do not delay care if you feel very unwell.

Preparing for Your Telemedicine Visit

Before your tele-visit, note when palpitations occur, how long they last, and any other symptoms. Have a list of your current medications and medical conditions ready. If possible, measure your pulse or heart rate during palpitations. Find a quiet, private place with good internet or phone connection. Be ready to describe your symptoms clearly to your provider.

What to Expect After Your Tele-Visit

Your provider may recommend lifestyle changes, such as reducing caffeine or managing stress. They might suggest follow-up tests like an ECG (electrocardiogram) or blood tests. If needed, they will refer you for in-person evaluation. Follow your provider's advice carefully and report any new or worsening symptoms promptly.

How to prepare for your tele-visit

• Note the timing, frequency, and duration of palpitations.
• Record any associated symptoms like dizziness, chest pain, or shortness of breath.
• List all current medications and supplements.
• Find a quiet, well-lit space with a reliable internet or phone connection.
• Have your identification and any previous medical records accessible if possible.

After your tele-visit

• Follow any lifestyle advice given by your healthcare provider.
• Schedule recommended tests or in-person appointments as advised.
• Monitor your symptoms and seek emergency care if red-flag symptoms appear.
• Keep a symptom diary to share in follow-up visits.
• Contact your provider if symptoms worsen or new symptoms develop.

FAQs

Can stress cause palpitations?

Yes, stress and anxiety can trigger palpitations by increasing adrenaline levels, which affect heart rate. Managing stress through relaxation techniques may reduce palpitations.

Are palpitations always a sign of heart disease?

Not always. Many palpitations are harmless and related to lifestyle factors like caffeine or medication. However, some palpitations may indicate heart rhythm problems, so evaluation is important.

Can I measure my heart rate during palpitations?

Yes, if possible, check your pulse at your wrist or neck during palpitations to note the heart rate and rhythm. This information can help your healthcare provider assess your condition.

When should I go to the emergency room for palpitations?

Go to the emergency room if palpitations come with chest pain, fainting, severe shortness of breath, or if you feel very unwell. These could signal a serious heart problem.

Can telemedicine replace all heart evaluations?

Telemedicine is useful for initial assessment and follow-up but cannot replace tests like ECG or emergency care that require in-person visits.

Sources

1. Palpitations — MedlinePlus, U.S. National Library of Medicine.
2. Arrhythmias (Irregular Heartbeats) — Mayo Clinic.
3. Heart Palpitations — Centers for Disease Control and Prevention (CDC).
4. Evaluation and Management of Palpitations — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical evaluation and treatment. If you experience emergency symptoms or worsening condition, seek immediate medical care.