Palpitations referral checklist

Urgency tier

• Same-day escalation for palpitations with syncope, chest pain, hypotension, or severe dyspnea.
• Expedited referral for recurrent symptomatic episodes with high-risk clinical context.
• Routine referral for persistent, non-urgent palpitations needing rhythm diagnosis support.

Minimum pre-referral workup

• Detailed symptom chronology including duration, triggers, and associated symptoms.
• Baseline cardiovascular exam and rhythm-focused assessment.
• Medication/stimulant review and comorbidity profile.

Referral packet checklist

• Event timeline and associated red-flag symptoms.
• Objective findings and any available ECG/rhythm data.
• Current medications, relevant labs, and family history context.

Pre-referral optimization tasks

• Counsel on stimulant reduction and hydration while awaiting assessment.
• Reinforce return precautions for syncope, chest pain, or worsening dyspnea.
• Arrange interim follow-up for symptom trend review.

References

• Canadian Cardiovascular Society guidelines (opens in a new tab)

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