Palpitations Flashcards
Definition
Increased awareness of normal heart heart or sensation of slow, rapid, or irregular heart rythm
Why do patients with anxiety have palpitations
They have lowered threshold at which disorders of rate and rythm lead to palpitations
3 pathophysiology by which there is palpitations
Augmentation of heart contractility
Arrhythmias
Cardiac neurosis
Physiological causes of heart contractility increase
Strenuous exercise
Alcohol, tea, coffee
Drugs - ephedrine, aminophylline, atropine
Pathological hypertrophy causes of heart contractility increase
Ventricular hypertrophy (hypertension, Valvular insufficiency , PDA , VSD)
Preload/afterload increase -> hypertrophy -> higher contractility -> palpitation
Dx (thyrotoxicosis, anemia)
Fever
Hypoglycemia
Arrhythmia leading to palpitations
Tachycardia
Bradycardia
Diastolic period prolong
Irregular beat
What is cardiac neurosis
Turbulence of sympathetic nerve & pneumogastric nerve
Causes of palpitation
Extracardiac dx
Cardiac dx ( Arrythmia etc)
Psychiatric causes
Drugs
diets
Extracardiac dx causing palpitations
anemia
electrolyte imbalance
fever
hyperthyroidism
hypoglycemia
hypovolemia
pheochromocytoma
vasovagal syndrom
Psychiatric causes of palpitations
Anxiety
Panic attacks
Palpitations history
Continuous or intermittent
Heartbeats regular or irregular
Approximate heart rate
Onset abrupt
What’s terminate the attack
Associated symptoms (chest pain lightheadedness polyuria)
Precipitating factors
History of structural heart disease
Disease causing palpitation with chest pain
Coronary heart disease
myocarditis
pericarditis
cardiac neurosis
Dx causing palpitation with fever
Acute infection
rheumatic fever
myocarditis
pericarditis
infective endocarditis
Dx with palpitations with syncope or twitch
High degree atrioventricular block
ventricular fibrillation
paroxysmal ventricular tachycardia
SSS
Dx causing palpitations with anemia
Acute hemorrhage
