Palpitations Flashcards
What are palpitations?
Sensation or awareness of one’s own heartbeat
Can manifest as a racing heart, skipped heartbeats, or a pounding/fluttering sensation in the chest or neck.
List four red flag symptoms of palpitations.
- Severe shortness of breath
- Chest pain
- Dizziness and light-headedness
- Fainting or blackouts
These symptoms warrant immediate medical evaluation.
What are the cardiac causes of palpitations?
- Arrhythmias: A-fib, atrial flutter, benign ectopy, Long-QT syndrome, ventricular/supraventricular tachycardias, bradycardias (e.g., Sick sinus syndrome, AV block)
- Structural abnormalities: Mitral regurg, aortic regurg, mitral valve prolapse, hypertrophic cardiomyopathy
- Syncope
- Pericarditis
These conditions can lead to abnormal heart rhythms and sensations.
What are some non-cardiac causes of palpitations?
- Drugs: Digoxin, beta-agonists, anticholinergics
- Substances: Caffeine, alcohol, nicotine, recreational drugs
- Systemic conditions: Anaemia, hyperthyroidism, GERD, hypoglycemia
- Psychiatric: Panic attack, generalised anxiety, depression
- High output states: Pregnancy, fever, exercise, stress, Paget’s
Non-cardiac factors can also contribute to the sensation of palpitations.
True or False: Palpitations can only be caused by cardiac issues.
False
Palpitations can have both cardiac and non-cardiac causes.
Fill in the blank: Palpitations can be associated with _______ conditions such as anaemia and hyperthyroidism.
systemic
Systemic conditions can affect the overall body, leading to sensations of palpitations.
What is a common psychiatric cause of palpitations?
Panic attack
Anxiety-related disorders can manifest physically as palpitations.
What is the first investigation for cardiac causes of palpitations?
12-lead ECG
What monitoring method is used if arrhythmia is suspected but the ECG is normal?
Ambulatory cardiac monitoring with Holter monitor or patch monitor
When is an ECHO indicated in the investigation of palpitations?
If structural heart disease is suspected
What test should be performed if palpitations are caused by exertion?
Exercise stress test
What type of study is indicated if the patient has associated dizziness or syncope?
Electrophysiology study
What laboratory test is included in the initial investigations for non-cardiac causes of palpitations?
FBC
List two laboratory tests that should be performed to evaluate thyroid function in the context of palpitations.
- Thyroid function tests
- Complete metabolic panel and inflammatory markers
Which serum electrolytes are specifically mentioned for evaluation in palpitations?
- Potassium
- Calcium
What is the initial management approach for palpitations?
Treat underlying cause
