Palpitations and Syncope Flashcards
what is the test in a pt w/ palpitations and syncope?
ECG during the event
how do you determine the most appropriate test to order in a pt w/ palpitations and syncope?
frequency and duration of sxs
when should an echocardiogram be ordered in a pt w/ palpitations and syncope?
if structural heart disease is suspected
diagnostic studies for suspected arrhythmias:
- initial diagnostic test in ALL pts
resting ECG
diagnostic studies for suspected arrhythmias:
- indicated for frequent (at least daily) arrythmias
ambulatory (24-hour) ECG
diagnostic studies for suspected arrhythmias:
- indicated for arrhythmias provoked by exercise
exercise ECG
diagnostic studies for suspected arrhythmias:
- indicated for infrequent arrhythmias > 1-2 minutes in duration
event monitor
diagnostic studies for suspected arrhythmias:
- indicated for infrequent symptomatic brief arrhythmias
loop recorder
diagnostic studies for suspected arrhythmias:
- indicated for very infrequent arrhythmias
implanted recorder
diagnostic studies for suspected arrhythmias:
- indicated for treatment (eg catheter ablation), NOT for diagnosis
electrophysiology study
diagnostic studies for suspected arrhythmias:
- advantage of resting ECG
diagnostic IF recorded during arrhythmia
diagnostic studies for suspected arrhythmias:
- disadvantage of resting ECG
arrhythmias usually not caught on resting ECG
diagnostic studies for suspected arrhythmias:
- advantage of ambulatory (24-hour) ECG
records everything for 24 hours
diagnostic studies for suspected arrhythmias:
- disadvantage of ambulatory (24-hour) ECG
not helpful if arrhythmia isn’t caught
diagnostic studies for suspected arrhythmias:
- advantage of exercise ECG
allows dx if arrhythmia really is exercise-related