Flashcards in Palpitations Deck (14):
1
What is a palpitation?
Defined as an abnormal awareness of the heart beat. They may notice that their heart beat skips a beat or has an irregular rhythm, is beating faster or slower than normal or is beating with greater strength.
2
What are some normal scenarios where palpitations may occur?
- exercise
- coffee
- anxiety
- but they may also occur due to problems
3
What are some pathological conditions where palpitations may arise?
- heart disease
- overactive thyroid gland
- anaemia
- anxiety
- congenital arrhythmia
4
How do patients describe palpitations?
- pounding
- thumping
- fluttering
- flopping
- skipping beats
- heart stopped
5
What is the process behind an arrhythmia?
In an arrhythmia, the heart isn't perfusing oxygen effectively and so it can cause pain or damage - palpitations are a symptom of this.
It is not necessarily an irregularity that is pathological but is most certainly an irregularity in the physiological process of SA --> AV--> Purkinje fibres & bindle of His.
6
Which of the cardinal features are important for Palpitations?
Quality
Severity
Time Course
Context
R/A
Associated
Medical History
Meds/Allergy
Family History
7
What should you ask for Quality
- irregular or regular palpitations
- tap it out for me?
- forceful/fluttering
8
What should you ask for Severity?
Time course if often an indication of severity.
- fast onset or slow progression
- how fast the beats are during the episode
9
What should you ask for time course?
- Onset (sudden is more likely to have a serious underlying cause)
- duration
- Offset
- Previous experience
10
What should you ask for Context?
- At rest? During activity?
- Drug use? Caffeine?
- Stress?
11
What should you ask for relieving and aggravating factors?
- anything improve the palpitations
- aggravating factors may be exercise, stress or coffee
12
What other associated features may be present?
- SOB
- Chest pain
- Fatigue
- Dizziness
- Blackouts
Ask about:
- other pain
- other symptoms
- medication
13
What are two common arrythmias?
Supraventricular Tachycardia (SVT): common in young people--> high regular HR; due to bypass of the SA node
Atrial Fibrillation (AF): more common in elderly --> irregular fast HR
14