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Palpitation Flashcards

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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
Focal neurological symptoms
Red flag in palpitations
26
Event duration more than 5 minutes
Red flag in palpitations
27
paroxysmal palpitation
arrhythmia
28
Persistent palpitation
volume overload (aortic regurgitation) persistent arrhythmia (atrial fibrillation)
29
Rapid regular palpitation (3)
sinus tachycardia Supraventricular tachycardia (SVT) Ventricular tachycardia (VT)
30
Rapid irregular palpitation
atrial fibrillation (AF)
31
Sudden onset and sudden cessation of palpitation
sick sinus syndrome
32
Giddiness or syncope palpitation
bradyarrythmias
33
Missing a beat,thump in chest
premature ventricular contraction
34
Palpitation + Chest pain could be an indicator of
acute coronary syndrome (ACS).
35
Palpitation + Acute dizziness/syncope could signify ……
serious arrhythmia
36
Palpitation + Focal neurology may indicate ….. (2)
cerebrovascular accident or event secondary to an arrhythmia
37
Palpitation + Sweating,anxiety, hypoglycemia ,diarrhea,weight loss
Hyperthyroid
38
Palpitation + shortness of breath /pitting edema
congestive heart failure
39
Palpitation with fever (5)
acute infection rheumatic fever myocarditis pericarditis infective endocarditis
40
Palpitation + Chest pain
Cardiac
41
Palpitation + Shortness of breath/ Orthopnea
Cardiac
42
Palpitation + Paroxysmal nocturnal dyspnea(PND)
Cardiac
43
Palpitation + Paedal oedema
Cardiac
44
Palpitation + Syncope
Cardiac
45
Palpitation + Cyanosis
Cardiac
46
Palpitation +↑JVP
Cardiac
47
Palpitation + Abnormal BP
Cardiac
48
Palpitation + Irregular pulse
Cardiac
49
Palpitation + Changes in S1 and S2
Cardiac
50
Palpitation + Murmurs
Cardiac
51
Palpitation + Symptoms and signs depend on underlying pathology
Non Cardiac
52
Initial phase of work-up All patients (3)
History Physical exam Electrocardiography
53
2ry phase of work-up Symptom rhythm correlation when arrhythmia is suspected (most patients) With frequent symptoms (1)
Holter monitor
54
2ry phase of work-up Symptom rhythm correlation when arrhythmia is suspected (most patients) With infrequent symptoms (2)
Transtelephonic monitor Loop recorder
55
Additional phase of work-up Directed by initial work-up (7)
-laboratory investigations- Thyroid function Renal function Electrolytes Chest X-ray -cardiac work-up as necessary- Echocardiogram Treadmill test Electrophysiological study (EP study)
56
Correct the root cause if possible
Management modality of Arrythmias
57
Reassurance
Management modality of Arrythmias
58
Vagal maneuvers-Valsalva maneuver / Carotid sinus massage
Management modality of Arrythmias
59
Cardioversion
Management modality of Arrythmias
60
Pharmacological therapy
Management modality of Arrythmias
61
Pacemaker/ICD implants
Management modality of Arrythmias
62
Radiofrequency ablation
Management modality of Arrythmias
63
Idiopathic palpitation
No identifiable cause of the palpitation
64
Structural heart disease Eg Mitral valve prolapse
Cause of palpitation
65
Normal pregnancy
Cause palpitation High output state
66
Fever
Cause palpitation High output state
67
Hypoglycemia
Cause palpitation Metabolic and endocrine
68
Pheochromocytoma
Cause palpitation Metabolic and endocrine+ Catecholamine excess
69
Stress/Exercis
Cause palpitation Catecholamine excess
70
Smoking, caffeine and alcohol
Cause palpitation Catecholamine excess
71
Sympathomimetic agents
A Medication which causes palpitation
72
Vasodilators
A Medication which causes palpitation
73
Anticholinergics
A Medication which causes palpitation
74
beta- agonists
A Medication which causes palpitation
75
Tricyclic antidepressants
A Medication which causes palpitation
76
Amlodipine
reflex tachycardia
77
Thyroxine excess may cause ….. (2)
tachycardia and atrial fibrillation
78
Electrolyte imbalance
Cause palpitation
79
Psychiatric disorders
Cause palpitation

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