![]() 1985 312:193-7.Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. Kennedy HL, Whitlock JA, Sprague MK, Kennedy LJ, Buckingham TA, Goldberg RJ. Utility of patient-activated cardiac event recorders in general clinical practice. Zimetbaum PJ, Kim KY, Ho KK, Zebede J, Josephson ME, Goldberger AL. Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. Zimetbaum PJ, Kim KY, Josephson ME, Goldberger AL, Cohel DJ. Cardiac event recorders yield more diagnoses and are more cost-effective than 48-hour Holter monitoring in patients with palpitations. Kinlay S, Leitch JW, Neil A, Chapman BL, Hardy DB, Fletcher PJ, et al. Utility and cost of event recorders in the diagnosis of palpitations, presyncope, and syncope. The evolving role of ambulatory monitoring in general clinical practice. Arrhythmias in patients with valvar aortic stenosis, valvar pulmonary stenosis, and ventricular septal defect. Wolfe RR, Driscoll DJ, Gersony WM, Hayes CJ, Keane JF, Kidd L, et al. Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, et al. Clinical approach to paroxysmal atrial fibrillation. Potential for misdiagnosis as panic disorder. Unrecognized paroxysmal supraventricular tachycardia. Lessmeier TJ, Gamperling D, Johnson-Liddon V, Fromm BS, Steinman RT, Meissner MD, et al. Evaluation of patients with palpitations. The clinical course of palpitations in medical outpatients. 1998 44:5-15.īarsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. Treatment of panic disorder in the general medical setting. Preliminary development of a screening instrument. 1996 42:465-72.īarsky AJ, Ahern DK, Delamater BA, Clancy SA, Bailey ED. Predictors of persistent palpitations and continued medical utilization. Panic disorder and the heart: a cardiology perspective. Psychiatric disorders in medical outpatients complaining of palpitations. 1993 150:780-5.īarsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. Orthostatic intolerance: a disorder of young women. 2001 134(9 pt 2):832-7.Īli YS, Daamen N, Jacob G, Jordan J, Shannon JR, Biaggioni I, et al. ![]() Palpitations, arrhythmias, and awareness of cardiac activity. The natural history of palpitations in a family practice. Evaluation and outcomes of patients with palpitations. Palpitations terminated by vagal maneuvers Supraventricular arrhythmia, atrial fibrillationĪtrioventricular nodal tachycardia, pericarditisĪtrial fibrillation, tachycardia with variable block ![]() Psychiatric etiology or catecholamine-sensitive arrhythmia Palpitations associated with emotional distress Valvular disease (e.g., aortic insufficiency, stenosis)įeeling of being unable to catch one’s breath Premature supraventricular or ventricular contractionsĬertain prescription and over-the-counter agents (e.g., digitalis, phenothiazine, theophylline, beta agonists) Trans-telephonic event monitors are more effective and cost-effective than Holter monitors for most patients.īradycardia caused by advanced arteriovenousīradycardia-tachycardia syndrome (sick sinus syndrome) Holter monitoring for 24 to 48 hours may be appropriate in patients with daily palpitations. When palpitations occur unpredictably or do not occur daily, an initial two-week course of continuous closed-loop event recording is indicated. Ambulatory electrocardiographic (ECG) monitoring usually is indicated if the etiology of palpitations cannot be determined from the patient’s history, physical examination, and resting ECG. No cause for the palpitations can be found in up to 16 percent of patients. Palpitations also can result from stimulant drugs, and over-the-counter and prescription medications. Nonarrhythmic cardiac problems, such as mitral valve prolapse, pericarditis, and congestive heart failure, and noncardiac problems, such as hyperthyroidism, vasovagal syncope, and hypoglycemia, can cause palpitations. Palpitations should be considered as potentially more serious if they are associated with dizziness, near-syncope, or syncope. However, any arrhythmia, including sinus tachycardia, atrial fibrillation, premature ventricular contractions, or ventricular tachycardia, can cause palpitations. Most patients with arrhythmias do not complain of palpitations. Palpitations-sensations of a rapid or irregular heartbeat-are most often caused by cardiac arrhythmias or anxiety.
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