Initial Grading Reminder
Grade 1: Mild symptoms; intervention not indicated
Grade 2: Intervention indicated
Assessment and Grading
Characterize the symptom (onset, pace)
Ask the patient:
Have you had this symptom in the past? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly? Have you started any new medications, OTCs, supplements, or marijuana?
Grade the symptom
Ask the patient:
How often does your heart seem to skip a beat or race? Does it only happen when you’re doing an activity or exercising or does it also do so at rest?
Patient Query Regarding Other Symptoms/Red Flags
Ask the patient:
Are you having any difficulty swallowing? Has your mood changed recently (are you a little hyper or depressed)?
Patient Factors to Consider That Affect the Approach to Intervention
Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?
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Click Here for Telephone Triage
Suggested Intervention
Patients with new-onset moderate or worse (or worsening) symptoms should be seen. Patients with any of the red-flag symptoms should be seen immediately.
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Click Here for In-Office Triage
Nursing Assessment of Potential Causes
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Differential Diagnosis
What do you suspect is the cause of your heart arrhythmia?
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