12.8.2013(palpitations) Flashcards
Irregular sustained palpitations
AF
Characteristics of palpitation
Intermittent Vs persistent
Regular Vs irregular
Regular sustained palpitations
Regular supra ventricular and ventricular tachycardias
CVS causes of palpitations
Premature atrial and ventricular contractions
Supra ventricular and ventricular arrythmias
Mitral valve prolapse(with or WITHOUT associated arrythmias)
AR
Atrial myxoma
Pulmonary embolism
Pericarditis
CCF
Common cause of Intermittent palpitation
Premature atrial or ventricular contractions
Which Beat is sensed by the patient in premature atrial or ventricular contraction?
Post extrasystolic beat
Are all arrythmias associated with palpitation?
MOST arrythmias are not associated with palpitation
Catecholaminergic Hyperdynamic states causing palpitations
Pheochromocytoma
Exercise
Stress
Drugs causing palpitations
Caffeine Theophylline Tobacco Atropine Thyroxine Cocaine Amphetamine Beta agonists Digitalis Phenothiazines
Psychiatric causes constitute _________ % of palpitations
31
Psychiatric causes of palpitation
Panic attacks
Anxiety
Somatisation
Features of psychiatric causes of palpitation
Longer duration(>15min) Associated with other symptoms
Miscellaneous causes of palpitations
Drugs Thyrotoxicosis Systemic mastocytosis Pheochromocytoma Ethanol Spontaneous skeletal muscle contractions of chest wall
Palpitations caused by sustained tachyarrythmias in CAD pts is associated with
Angina
Dyspnea
Palpitations in patients with ventricular dysfunction,AS,HOCM,MS are associated with
Dyspnea
Palpitations due to life threatening arrythmias are associated with
Symptoms of hemodynamic compromise like syncope,light headedness
Strategies that are better for evaluation of pts with unexplained,recurrent palpitations
Implantable loop recorder
Mobile cardiac outpatient telemetry
Rx of benign atrial or ventricular premature contractions
Betablockers
Arrythmias that cause palpitations
Any arrythmia
Non-cardiac causes of palpitations
Hypoglycemia Vasovagal syncope Hyperthyroidism Fever Anemia Electrolyte imbalance Hypovolemia Pulmonary disease
Nonarrythmic cardiac causes of palpitations
ASD,VSD congenital heart disease CCF Cardiomyopathy MVP Pacemaker induced tachycardia Pericarditis Valvular diseases
Pounding or jumping palpitations when the patient is quietly sitting down or lying
Premature contractions