-
The Medical Clinics of North America Sep 2019Palpitation is common. It is often accompanied by dizziness, lightheadedness, near syncope, and even syncope. It may be difficult to confirm a diagnosis in patients with... (Review)
Review
Palpitation is common. It is often accompanied by dizziness, lightheadedness, near syncope, and even syncope. It may be difficult to confirm a diagnosis in patients with infrequent symptoms. Several tools are available to document arrhythmias in the workup of a patient with palpitation, including 24-hour Holter monitoring, 30-day external continuous monitoring, and implantable loop recorders. A number of private companies are now able to empower patients to monitor heart rates and even give accurate rhythm strips. This article reviews the current data on how to make the diagnosis and which tools to use in the primary care setting.
Topics: Arrhythmias, Cardiac; Electrocardiography; Electrocardiography, Ambulatory; Humans; Symptom Assessment; Time Factors
PubMed: 31378325
DOI: 10.1016/j.mcna.2019.05.005 -
Indian Pacing and Electrophysiology... 2021
PubMed: 33503471
DOI: 10.1016/j.ipej.2021.01.008 -
Pediatric Clinics of North America Oct 2020Syncope and palpitations are common complaints for patients presenting to their primary care provider. They represent symptoms that most often have a benign etiology but... (Review)
Review
Syncope and palpitations are common complaints for patients presenting to their primary care provider. They represent symptoms that most often have a benign etiology but rarely can be the first warning sign of a serious condition, such as arrhythmias, structural heart disease, or noncardiac disease. The history, physical examination, and noninvasive testing can, in most cases, distinguish benign from pathologic causes. This article introduces syncope and palpitations, with emphasis on the differential diagnoses, initial presentation, diagnostic strategy, and various management strategies.
Topics: Arrhythmias, Cardiac; Child; Diagnosis, Differential; Electrocardiography; Heart Conduction System; Heart Rate; Humans; Syncope
PubMed: 32888682
DOI: 10.1016/j.pcl.2020.05.004 -
The Journal of Laboratory and Clinical... Nov 1948
Topics: Arrhythmias, Cardiac; Brugada Syndrome; Cardiac Conduction System Disease; Heart Conduction System; Heart Rate; Humans
PubMed: 18933522
DOI: No ID Found -
Medicine Illustrated Jan 1955
Topics: Arrhythmias, Cardiac; Brugada Syndrome; Cardiac Conduction System Disease; Heart; Heart Conduction System; Humans; Neurocirculatory Asthenia; Tachycardia
PubMed: 13235039
DOI: No ID Found -
The American Journal of Medicine Nov 2022Premature ventricular complexes/contractions (PVCs) are relatively common, occurring in 3%-20% of the general population, and are often found during work-up of... (Review)
Review
Premature ventricular complexes/contractions (PVCs) are relatively common, occurring in 3%-20% of the general population, and are often found during work-up of palpitations or incidentally on routine electrocardiographic testing. They are usually considered benign but can be a sign of underlying cardiac disease and cause significantly impairing symptoms. While often thought of as a problem for the cardiologist, it is not uncommon for PVCs to be identified initially in a primary care or inpatient general medicine setting. This paper will review etiologies, epidemiology, evaluation, and management of PVCs for the internist.
Topics: Humans; Ventricular Premature Complexes; Electrocardiography
PubMed: 35907515
DOI: 10.1016/j.amjmed.2022.07.004 -
Scientific Reports Sep 2020Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease with diversified clinical presentation and it is important to identify new predictors of clinical...
Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease with diversified clinical presentation and it is important to identify new predictors of clinical outcomes and survival in HCM patients. In our study, 206 HCM patients were compared with respect to major adverse cardiovascular and cerebrovascular events. By multivariable logistic analysis, we determined that palpitation, together with chronic heart failure (CHF) > 1 year, was an independent predictor of major adverse cardiovascular and cerebral events (MACCE) in HCM patients (OR 3.24, 95% CI 1.60-6.57, P = 0.001). Specially, palpitation was related to higher prevalence of rehospitalization (OR 3.86, 95% CI 2.08-7.08, P < 0.001), cardiac death (OR 2.96, 95% CI 1.05-8.32, P = 0.04) and heart failure exacerbation (OR 4.07, 95% CI 2.04-8.13, P < 0.001). However, patients presented with palpitation did not show a significantly different cardiac phenotype and function. Finally, palpitation predicted a poor prognosis in HCM patients without atrial fibrillation by utilizing Kaplan-Meier analysis (P = 0.041). In conclusion, palpitation could be a new predictor of clinical outcomes and overall survival in HCM patients.
Topics: Atrial Fibrillation; Cardiomyopathy, Hypertrophic; China; Echocardiography; Female; Hospitalization; Humans; Male; Middle Aged; Prognosis; Risk Factors; Survival Rate
PubMed: 32913229
DOI: 10.1038/s41598-020-71797-y -
Menopause (New York, N.Y.) May 2021Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to...
OBJECTIVE
Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women.
METHODS
Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants.
RESULTS
Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]).
CONCLUSIONS
Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.
Topics: Anxiety; Arrhythmias, Cardiac; Cross-Sectional Studies; Female; Hot Flashes; Humans; Menopause; Middle Aged; Quality of Life; Surveys and Questionnaires; Vasomotor System
PubMed: 34033601
DOI: 10.1097/GME.0000000000001776 -
BMJ Case Reports Jun 2021A 60-year-old man presented with headache, giddiness, abdominal pain and palpitation. When evaluated outside for the same, the patient was diagnosed to have hypertension...
A 60-year-old man presented with headache, giddiness, abdominal pain and palpitation. When evaluated outside for the same, the patient was diagnosed to have hypertension and started on antihypertensives for which he did not respond. ECG was suggestive of non-ST elevation myocardial infarction. The patient was subjected to a coronary angiogram, which was normal. Patient had multiple episodes of fluctuating blood pressures. CT of the abdomen showed a 7.1×5.6×8.2 cm mass in the left adrenal gland suggestive of a pheochromocytoma. Serum, urine metanephrines and normetanephrines were elevated. After discussing with the multidisciplinary team, the patient was stabilised with alpha blockers and taken up for laparoscopic left adrenalectomy. Histopathology was reported as pheochromocytoma with a Pheochromocytoma Adrenal Scaled Score of 10/20 suggestive of malignancy. This is one such case of a malignant pheochromocytoma, which was managed successfully despite the perplexities faced in stabilising the crisis followed by laparoscopic resection in a moribund patient.
Topics: Adrenal Gland Neoplasms; Adrenalectomy; Chest Pain; Humans; Male; Middle Aged; Normetanephrine; Pheochromocytoma
PubMed: 34167972
DOI: 10.1136/bcr-2020-239991