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Palpitation Flashcards

1
Q

subjective symptom

an unpleasant awareness of heartbeat
[ forceful, slow , rapid, or irregular]

A

Palpitations

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2
Q

unusually unpleasant, fast, slow ,forceful ,skipped or extra beats, or even as chest pain or breathlessness

A

Palpitations

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3
Q

Palpitations may be due to (3)

A

Alteration in heart rate

Alteration in heart rhythm

Augmentation of myocardial contraction

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4
Q

sinus tachycardia & bradycardia
Are ….

A

Alteration in heart rate

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5
Q

Atrial fibrillation
Is …..

A

Alteration in heart rhythm

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6
Q

anxiety states & drugs
Are….

A

Augmentation of myocardial contraction

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7
Q

Why to evaluate and treat arrhythmias (2)

A

Eliminate symptoms

Prevent death and hemodynamic collapse due to life-threatening arrhythmias

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8
Q

life-threatening arrhythmias (2)

A

ventricular tachycardia and ventricular fibrillation

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9
Q

degree of palpitation may not be equal to …….

A

Severity of heart disease

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10
Q

Acute coronary syndrome

A

Common cause of palpitation

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11
Q

Arrhythmia

A

Common cause of palpitation

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12
Q

Anxiety

A

Common cause of palpitation

Catecholamine excess

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13
Q

Thyroid dysfunction

A

Common cause of palpitation

Metabolic and endocrine

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14
Q

Infection

A

Common cause of palpitation

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15
Q

Anaemia

A

Common cause of palpitation

High output states

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16
Q

Medications- side effects

A

Common cause of palpitation

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17
Q

Heart beat irregular consider …….. (2)

A

Ectopic beats

Atrial fibrillation

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18
Q

Heart beat regular
+ there are discrete attacks of tachycardia
Consider……… (2)

A

Supraventricular tachycardia

Ventricular tachycardia

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19
Q

Heart beat regular
+ there are no discrete attacks of tachycardia
Consider……… (2)

A

Sinus tachycardia

High stroke volume

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20
Q

Sinus tachycardia
High stroke volume
Due to …… (3)

A

Anaemia
Anxiety
Valve disease

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21
Q

Chest pain

A

Red flag in palpitations

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22
Q

Acute dizziness or syncope

A

Red flag in palpitations

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23
Q

Shortness of breath

A

Red flag in palpitations

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24
Q

Hypotension

A

Red flag in palpitations

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25
Q

Focal neurological symptoms

A

Red flag in palpitations

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26
Q

Event duration more than 5 minutes

A

Red flag in palpitations

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27
Q

paroxysmal palpitation

A

arrhythmia

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28
Q

Persistent palpitation

A

volume overload (aortic regurgitation)

persistent arrhythmia (atrial fibrillation)

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29
Q

Rapid regular palpitation (3)

A

sinus tachycardia
Supraventricular tachycardia (SVT)
Ventricular tachycardia (VT)

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30
Q

Rapid irregular palpitation

A

atrial fibrillation (AF)

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31
Q

Sudden onset and sudden cessation of palpitation

A

sick sinus syndrome

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32
Q

Giddiness or syncope palpitation

A

bradyarrythmias

33
Q

Missing a beat,thump in chest

A

premature ventricular contraction

34
Q

Palpitation + Chest pain could be an indicator of

A

acute coronary syndrome (ACS).

35
Q

Palpitation + Acute dizziness/syncope could signify ……

A

serious arrhythmia

36
Q

Palpitation + Focal neurology may indicate ….. (2)

A

cerebrovascular accident or

event secondary to an arrhythmia

37
Q

Palpitation + Sweating,anxiety, hypoglycemia ,diarrhea,weight loss

A

Hyperthyroid

38
Q

Palpitation + shortness of breath /pitting edema

A

congestive heart failure

39
Q

Palpitation with fever (5)

A

acute infection
rheumatic fever
myocarditis
pericarditis
infective endocarditis

40
Q

Palpitation + Chest pain

41
Q

Palpitation + Shortness of breath/ Orthopnea

42
Q

Palpitation + Paroxysmal nocturnal dyspnea(PND)

43
Q

Palpitation + Paedal oedema

44
Q

Palpitation + Syncope

45
Q

Palpitation + Cyanosis

46
Q

Palpitation +↑JVP

47
Q

Palpitation + Abnormal BP

48
Q

Palpitation + Irregular pulse

49
Q

Palpitation + Changes in S1 and S2

50
Q

Palpitation + Murmurs

51
Q

Palpitation + Symptoms and signs depend on underlying pathology

A

Non Cardiac

52
Q

Initial phase of work-up
All patients (3)

A

History
Physical exam
Electrocardiography

53
Q

2ry phase of work-up
Symptom rhythm correlation when arrhythmia is suspected (most patients)
With frequent symptoms (1)

A

Holter monitor

54
Q

2ry phase of work-up
Symptom rhythm correlation when arrhythmia is suspected (most patients)
With infrequent symptoms (2)

A

Transtelephonic monitor
Loop recorder

55
Q

Additional phase of work-up
Directed by initial work-up (7)

A

-laboratory investigations-
Thyroid function
Renal function
Electrolytes

Chest X-ray

-cardiac work-up as necessary-
Echocardiogram
Treadmill test
Electrophysiological study (EP study)

56
Q

Correct the root cause if possible

A

Management modality of
Arrythmias

57
Q

Reassurance

A

Management modality of
Arrythmias

58
Q

Vagal maneuvers-Valsalva maneuver / Carotid sinus massage

A

Management modality of
Arrythmias

59
Q

Cardioversion

A

Management modality of
Arrythmias

60
Q

Pharmacological therapy

A

Management modality of
Arrythmias

61
Q

Pacemaker/ICD implants

A

Management modality of
Arrythmias

62
Q

Radiofrequency ablation

A

Management modality of
Arrythmias

63
Q

Idiopathic palpitation

A

No identifiable cause of the palpitation

64
Q

Structural heart disease
Eg Mitral valve prolapse

A

Cause of palpitation

65
Q

Normal pregnancy

A

Cause palpitation

High output state

66
Q

Fever

A

Cause palpitation

High output state

67
Q

Hypoglycemia

A

Cause palpitation

Metabolic and endocrine

68
Q

Pheochromocytoma

A

Cause palpitation

Metabolic and endocrine+ Catecholamine excess

69
Q

Stress/Exercis

A

Cause palpitation

Catecholamine excess

70
Q

Smoking, caffeine and alcohol

A

Cause palpitation

Catecholamine excess

71
Q

Sympathomimetic agents

A

A Medication which causes palpitation

72
Q

Vasodilators

A

A Medication which causes palpitation

73
Q

Anticholinergics

A

A Medication which causes palpitation

74
Q

beta- agonists

A

A Medication which causes palpitation

75
Q

Tricyclic antidepressants

A

A Medication which causes palpitation

76
Q

Amlodipine

A

reflex tachycardia

77
Q

Thyroxine

excess may cause ….. (2)

A

tachycardia and atrial fibrillation

78
Q

Electrolyte imbalance

A

Cause palpitation

79
Q

Psychiatric disorders

A

Cause palpitation

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