palpitations Flashcards
1
Q
hpi-what do you want to ask?
A
dizziness?
caffeine? diet pills? stress?
anemia? fatigue? lightheadedness, gi blod loss, menorrhagia?
family hx of dysrhythmias?
2
Q
midsystolic click with or without a late systolic murmur
A
mitral valve prolapse
3
Q
benign rhythm disturbances include
A
premature atrial contractions sinus tachycardia sinus bradycardia sinus pauses less than 3 seconds isolated unifocal premature ventricular contractions
4
Q
noncardiac causes of palpitations
A
anemia electrolyte disturbances hyperthryroidism hypothyroidism hypoglycemia hypovolemia fever pheochromoyctoma pulm dis vasovagal syncope meds and substances
5
Q
with palpitations, if pt is >50, always consider
A
coronary artery disease
6
Q
PE for palpitations
A
vital signs (BP, HR) thyroid gland resting tremor, brisk reflexes palpate PMI heart rate and rhythm
7
Q
tx for chronic a fib
A
beta blockers or Ca ch blockers may attempt to get return to normal sinus rhythm w electrical cardioversion or antiarrhythmic drugs such as amiodarone, sotalol or class IC drugs
8
Q
causes of palpitations
A
primary rhythm disturbances ( most common) anxiety meds structural heart dis noncardiac causes
9
Q
anyone with suspected structural heart prob should be evaluated by what before a stress test?
A
echocardiogram (b/c suspected hypertrophic cardiomyopathy or severe aortic stenosis pts should avoid stress tests as they may develop heart rhythm disturbances)
