Cardiac Arrythmias
Charles Theisler in Adjuvant Medical Care, 2023
An arrythmia refers to any change from the normal sequence of electrical impulses that affects either the rate or rhythm of the heartbeat. Irregular heartbeats such as atrial fibrillation, bradycardia, tachycardia, conduction disorders, rhythm disorders, ventricular fibrillation, and premature contractions are arrythmias, also known as dysrhythmias. Palpitations are disturbances in the rhythm that can be felt and can make the heart feel like it is beating too hard or too fast, skipping a beat, or fluttering. Symptoms and signs of arrhythmia often include chest pain, dizziness, breathlessness, palpitations, fainting, chest fluttering, tachycardia or bradycardia, and shortness of breath. Arrythmia is the most common cause of sudden cardiac arrest. There are a wide variety of causes for arrythmias, such as myocardial infarction, coronary heart disease (CAD), hypertension (HTN), thyroid problems, drug abuse, diabetes, certain medications, etc. Smoking and excessive alcohol or caffeine use also increase the risk of an arrythmia.
Arrhythmia
Lauren A. Plante in Expecting Trouble, 2018
The diagnostic evaluation of pregnant women for an arrhythmia is similar to that of the general population. Evaluation includes a complete history, physical examination, and 12-lead electrocardiogram (ECG) ± transthoracic echocardiogram to assess cardiac structure and function. Laboratory testing includes complete blood count and thyroid function to rule out significant anemia and thyrotoxicosis, respectively. A combination of history and physical examination, ECG, and limited laboratory testing allows a specific diagnosis in about one-third of the patients (14). The most common cause of palpitations is cardiac (43%), followed by psychiatric (31%) illness such as anxiety, and 10% are due to medications or other causes (15). Other conditions that may cause the symptoms of an arrhythmia include mitral valve prolapse, vasovagal syncope, anxiety, hypoglycemia, heart failure, pericarditis, electrolyte imbalance, pulmonary embolism, infection, and hemorrhage. After excluding these conditions, diagnosis may ultimately be attributed to normal physiological changes in pregnancy.
Cardiovascular Symptoms: Is It Pregnancy or the Heart?
Afshan B. Hameed, Diana S. Wolfe in Cardio-Obstetrics, 2020
Cardiovascular disease (CVD) has emerged as the leading cause of maternal mortality in the United States, accounting for over one-third of all pregnancy-related deaths. A significant proportion of these deaths are preventable [1]. One of the key elements in CVD-related deaths is the inability of the health care provider to identify the presenting symptoms as markers for CVD, thus causing delays or missed diagnosis [2]. Pregnancy is a state of hemodynamic overload that may result in signs and symptoms similar to those of cardiovascular disease. It is often challenging to distinguish physiologic symptoms of pregnancy from heart disease. Common symptoms include palpitations, shortness of breath (SOB), fatigue, chest pain, and dizziness. It is imperative that the obstetrics care provider be able to differentiate benign pregnancy symptoms from those of potentially life-threatening causes. This chapter provides an overview of the common cardiovascular symptoms of pregnancy and the California Maternal Quality Care Collaborative Cardiovascular (CMQCC) disease in pregnancy toolkit designed to identify pregnant women who are at increased risk of CVD requiring further cardiovascular evaluation [3].
Effect of menopausal symptom treatment options on palpitations: a systematic review
Published in Climacteric, 2022
Y. Sheng, J. S. Carpenter, C. D. Elomba, J. S. Alwine, M. Yue, C. X. Chen, J. E. Tisdale
This review contributes to future research and clinical practice in the field of palpitations. None of the reviewed articles used ECG devices to evaluate palpitations and exclude arrhythmias, such as atrial fibrillation. Several wearable ECG devices are approved as clinically diagnostic for accurately capturing heart rate and rhythm disturbances [82]. Future studies should use clinically diagnostic ECG devices to evaluate rhythm and rate disturbances occurring with the felt sensation of palpitations to better understand the symptoms and develop treatments. Clinicians should be aware that women reporting palpitations may need referral to a cardiologist to further evaluate the symptoms and any underlying arrhythmia, and to determine a best course of treatment. We note that, while beta-blockers effectively control the heart rhythm when used appropriately [83], there is scant evidence regarding their use for menopausal symptoms [55,84].
Clinical electrophysiology of the aging heart
Published in Expert Review of Cardiovascular Therapy, 2022
Kyle Murray, Muizz Wahid, Kannayiram Alagiakrishnan, Janek Senaratne
Palpitations are a heightened or uncomfortable awareness of heartbeat and are a common reason for elderly patients to present to a clinic or hospital [34]. Palpitations are divided into cardiac and noncardiac causes. Noncardiac causes are further subclassified into psychosomatic, medical illness, and pharmacologic mediated. Cardiac causes are secondary to arrhythmias (e.g. tachyarrhythmia, bradyarrhythmia, and extrasystoles) and structural heart disease (e.g. valvular disease, heart failure, and hypertrophic cardiomyopathy). In adults presenting to emergency with palpitations, 47% of cases are a cardiac cause [35]. Patients who are elderly, male, have irregular palpitations, palpitations lasting >5 minutes, and history of coronary artery disease (CAD) have a high likelihood of a cardiac cause [24].
Insertable cardiac monitors: current indications and devices
Published in Expert Review of Medical Devices, 2019
Rafi Sakhi, Dominic A.M.J. Theuns, Tamas Szili-Torok, Sing-Chien Yap
In patients with infrequent episodes of palpitations short-term ambulatory ECG monitoring is usually insufficient. In the RUP study, 50 patients with infrequent (≤1 episode per month), sustained (>1 min) palpitations and initial negative diagnostic workup were randomized to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiology study) or to an ICM (Reveal Plus, Medtronic) with 1-year monitoring [54]. The diagnostic yield was higher in the ICM group (73% versus 21%, p < 0.001). Palpitations were completely eliminated in the patients with an arrhythmic diagnosis using ablation, pacemaker, or drugs. Furthermore, the overall cost per diagnosis in the ICM group was lower compared to the conventional strategy group. There is a class IIa indication for an ICM in selected patients with severe infrequent symptoms when other ECG monitoring systems fail to document the underlying cause [55].
Related Knowledge Centers
- Anxiety
- Cardiac Cycle
- Chest Pain
- Dizziness
- Perspiration
- Shortness of Breath
- Thorax
- Systole
- Headache
- Cardiac Muscle
- Shortness of Breath