CVS 2: Palpitations

Question 1

What is Wolff-Parkinson-White syndrome?

Answer 1

A relatively common heart condition that causes the heart to beat abnormally fast for periods of time. The cause is an extra electrical connection in the heart. This problem with the heart is present at birth (congenital), although symptoms may not develop until later in life.

Question 2

What are some common causes of palpitations?

Answer 2

• Cardiac arrhythmias - Structural heart disease (cardiomyopathy, congenital heart disease) - Psychiatric (anxiety, panic attack, depression) - Drugs - Systemic conditions

Question 3

What systemic conditions can cause palpitations?

Answer 3

• Hyperthyroidism - Hypoglycaemia (diabetic?)

Question 4

In examination, what are you looking for?

Answer 4

• Signs of metabolic conditions and sepsis - Signs of structural heart disease - Signs of poor cardiac output as a result of the arrhythmia

Question 5

Placement of stethoscope for heart sounds

Answer 5

Question 6

What to listen for in cardiac murmurs?

Answer 6

• Timing: systolic vs diastolic
• Site heard loudest
• Radiation of murmur
• Volume
• Associated features

Question 7

Placement of stethoscope

Answer 7

Question 8

Heart murmur: some conditions

Answer 8

Question 9

What causes Wolff-Parkinson-White syndrome?

Answer 9

Abnormal conductive cardiac tissue between the atria and ventricles –> accessory pathway

Question 10

Symptoms of Wolff-Parkinson-White syndrome?

Answer 10

• Some are asymptomatic
• Palpitations, dizziness, syncope, chest pain, sweating

Question 11

Wolff-Parkinson-White syndrome ECG

Answer 11