Arrhythmia – outpatient, new Dx

Arrhythmia: (new diagnosis)

  • Order an EKG (in the clinic)
  • Order a Cardionet Holter Monitor (ETSU Heart)
  • Cardiology referral (ETSU Heart)
    • Do NOT start Metoprolol if tachycardic (hold Metoprolol until after Holter monitor is complete!!!)
    • Consider starting Omeprazole if chest pain/acid reflux may also be involved.
  • Labs ordered: CBC, CMP, TSH, Magnesium, Lipid Panel
  • Follow up in 4-6 weeks.
    • Recommendations in the meantime: Limit/avoid caffeine, smoking, alcohol, and supplements. Get plenty of rest.
      • Cut down on coffee. (causes PVCs)
      • Cut down on alcohol.
      • Quit tobacco use.
      • Quit using supplements.
      • Get more rest.
    • Ex: Atypical chest pain, irregular heartbeat, palpitations, reported tachycardia: An EKG was performed today in the clinic, which showed normal sinus rhythm. The patient was referred to Cardiology (ETSU Heart) today. A Cardionet Holter monitor is ordered to assess for arrhythmia as the underlying etiology of her symptoms. No medications were started at this time [may start Omeprazole if possibly acid reflux related; do NOT start beta-blocker as this will askew Holter monitor results!]
    • Labs ordered today: CBC, CMP, Lipid Panel, TSH.

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