Medicine · Referral letter · Task 2

Intermittent palpitations awaiting specialist assessment

You are a GP at Harbour Practice. Today is 24 September 2026. Using the case notes, write a referral letter to Dr Martin Ellis, Consultant Cardiologist, Harbour Hospital, 4 Dock Road, Fairford. Request assessment of intermittent symptoms, explaining what the normal resting ECG does and does not establish. Write approximately 180-200 words in the body of your letter.

Patient: Aisha Nolan, born 22 April 1985

Case notes

• N01Patient: Aisha Nolan; episodic palpitations for two months; episodes occur at rest and last 5-10 minutes; approximately twice weekly.
• N02Associated features: occasional light-headedness during episodes; no loss of consciousness or chest pain reported; symptom-free at today’s consultation.
• N03Investigations: resting ECG today showed sinus rhythm; blood count and thyroid tests reported within laboratory reference ranges; copies attached.
• N04History: no known cardiac disease; mother has atrial fibrillation; no regular medication; no known drug allergies.
• N05Plan: cardiology referral for assessment of intermittent symptoms and consideration of ambulatory monitoring; no rhythm diagnosis confirmed.
• N06Patient concern: normal ECG may mean symptoms will be dismissed; GP explained brief resting recording does not capture every intermittent event.
• N07Practical: rotating work shifts; appointment contact by personal mobile; given practice’s agreed escalation instructions if symptoms change.
• N08Other: teaches art; recently joined pottery group; prefers green tea.