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Palpitation

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1. Assessment of palpitations

Assessment of palpitations Assessment of palpitations - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of palpitations Last reviewed: February 2019 Last updated: June 2018 Summary Palpitations are defined as the abnormal awareness of one's own heartbeat. It is a common complaint seen in the outpatient setting in virtually all age groups and demographics. Most palpitations are due to non-arrhythmic (...) aetiologies that occur during normal sinus rhythm. A significant proportion of palpitations are due to non-life-threatening, treatable cardiac conditions. They include premature ventricular contractions, premature atrial contractions, and supraventricular tachycardias such as atrial fibrillation, atrial flutter, atrioventricular nodal re-entry tachycardia, atrial tachycardia, and atrioventricular re-entry tachycardia or Wolff-Parkinson-White syndrome. Ironically, the most common rhythm seen when

2018 BMJ Best Practice

3. Multi-centre Randomised Controlled Trial of a Smartphone-based Event Recorder Alongside Standard Care Versus Standard Care for Patients Presenting to the Emergency Department with Palpitations and Pre-syncope: The IPED (Investigation of Palpitations in th Full Text available with Trip Pro

Multi-centre Randomised Controlled Trial of a Smartphone-based Event Recorder Alongside Standard Care Versus Standard Care for Patients Presenting to the Emergency Department with Palpitations and Pre-syncope: The IPED (Investigation of Palpitations in th Patients with palpitations and pre-syncope commonly present to Emergency Departments (EDs) but underlying rhythm diagnosis is often not possible during the initial presentation. This trial compares the symptomatic rhythm detection rate (...) of a smartphone-based event recorder (AliveCor) alongside standard care versus standard care alone, for participants presenting to the ED with palpitations and pre-syncope with no obvious cause evident at initial consultation.Multi-centre open label, randomised controlled trial. Participants ≥ 16 years old presenting to 10 UK hospital EDs were included. Participants were randomised to either (a) intervention group; standard care plus the use of a smartphone-based event recorder or (b) control group; standard

2019 Eclinicalmedicine Controlled trial quality: predicted high

4. Multi-centre randomised controlled trial of a smart phone-based event recorder alongside standard care versus standard care for patients presenting to the Emergency Department with palpitations and pre-syncope - the IPED (Investigation of Palpitations in Full Text available with Trip Pro

Multi-centre randomised controlled trial of a smart phone-based event recorder alongside standard care versus standard care for patients presenting to the Emergency Department with palpitations and pre-syncope - the IPED (Investigation of Palpitations in Palpitations and pre-syncope are together responsible for 300,000 annual Emergency Department (ED) attendances in the United Kingdom (UK). Diagnosis of the underlying rhythm is difficult as many patients are fully recovered on ED arrival (...) ; and examination and presenting electrocardiogram (ECG) are commonly normal. The only way to establish the underlying heart rhythm is to capture an ECG during symptoms. Recent technology advances have led to several novel ECG monitoring devices appearing on the market. This trial aims to compare the symptomatic rhythm detection rate at 90 days of one such smart phone-based event recorder (AliveCor Heart Monitor and AliveECG) with standard care for participants presenting to the ED with palpitations and pre

2018 Trials

5. A 22-Year-Old Woman With Fever, Palpitations, and a Cardiac Mass. (Abstract)

A 22-Year-Old Woman With Fever, Palpitations, and a Cardiac Mass. A 22-year-old woman was admitted to our department for fever of unknown origin. The patient reported intermittent fever and nonspecific abdominal pain for several years. Six months before admission she started complaining of palpitations and exertional dyspnea. She had no weight loss, chest pain, headache, or joint complaints. Medical history was unremarkable. She did not consume tobacco, alcohol, or illicit drugs. The patient

2019 Chest

6. New Onset Palpitations, Chest Pain, Dyspnea, and Diaphoresis in a 65-Year-Old Woman. (Abstract)

New Onset Palpitations, Chest Pain, Dyspnea, and Diaphoresis in a 65-Year-Old Woman. A woman with the new onset of cardiac symptoms was in atrial fibrillation with a wide QRS complex that was not typical of bundle branch block. After electrical cardioversion, a short PR interval and delta waves indicated the presence of an accessory atrioventricular pathway. This left lateral atrioventricular bypass tract was subsequently ablated.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Cardiology

7. Palpitations of unusual etiology

Palpitations of unusual etiology Dr. Smith's ECG Blog: Palpitations of unusual etiology Tuesday, May 8, 2018 Written by Pendell Meyers, with edits by Steve Smith A male in his 60s with history of HTN and previous complaint of palpitations but with a negative holter monitor workup, presented to our ED with palpitations for the past hour, associated with lightheadedness and presyncope. He was hemodynamically stable and well appearing, but was symptomatic with palpitations and lightheadedness (...) . Although this comes from a Hennepin paramedic, the patient was not brought to ... I have put up one post with 10 similar cases here . Don't miss the comments at the bottom! I was sent this ECG with the following ... Written by Pendell Meyers, edits by Steve Smith This will be too easy for most long-time readers, but if you are at that level, sit back... This case comes from Sam Ghali ( @EM_RESUS ). A 60-year-old man calls 911 after experiencing sudden onset chest pain, palpitations, a... Written

2018 Dr Smith's ECG Blog

8. Palpitations and Chest Tightness: Should You Activate the Cath Lab (or Give Thrombolytics)?

Palpitations and Chest Tightness: Should You Activate the Cath Lab (or Give Thrombolytics)? Dr. Smith's ECG Blog: Palpitations and Chest Tightness: Should You Activate the Cath Lab (or Give Thrombolytics)? Tuesday, June 26, 2018 This case was sent by Jessica Carmichael, and Emergency Physician on active duty at Irwin Army Community Hospital in Fort Riley, Kansas. She trained at Brooke Army Medical Center. ECG and Case I was sent this ECG with some information, but I looked only at the ECG (...) , the very marked J-waves in many leads, and the short QT interval make this very unlikely to be LAD occlusion. But it does meet STEMI "criteria" in multiple leads. Here is the full history: "Basics: 28 yo AA male who had a history of WPW who had sudden onset of heart palpitations and chest tightness 5/10 at rest. Had had ablation in 2016. No issues since. Presented with no other associated ROS, save for lightheadedness. Denies drug use, UDS neg. No family history. Physically fit. Systolic BP 112. Sats

2018 Dr Smith's ECG Blog

9. A 38-Year-Old Man With a 2-Month History of Fever, Cough, Palpitations, and Weight Loss. Full Text available with Trip Pro

A 38-Year-Old Man With a 2-Month History of Fever, Cough, Palpitations, and Weight Loss. A 38-year-old man of Indian origin, who migrated to Greece 13 years prior to presentation, was admitted to our hospital with a 2-month history of nonprogressive, intermittent (mostly evening), low-grade (up to 38.5°C) fever, accompanied by night sweats, dry cough, mild dyspnea on exertion (modified Medical Research Council Dyspnea Scale grade 1), anorexia, fatigue, and weight loss of 10 kg. He also (...) experienced continuous palpitations, which were regular, not associated with chest pain or dizziness, and aggravated on exertion. He had not taken any medication for his condition, except for antipyretic agents, nor had he sought medical advice. He was a nonsmoker, had a history of past alcohol dependence, and had been hospitalized twice for acute pancreatitis due to hypertriglyceridemia. He had also been diagnosed with diabetes mellitus, presumably poorly controlled because he mentioned not taking any

2018 Chest

10. A 67-Year-Old Man With Palpitations During Sleep. Full Text available with Trip Pro

A 67-Year-Old Man With Palpitations During Sleep. A 67-year-old man with a history of atrial fibrillation (AF) presented to his physician with symptoms of episodic, nighttime palpitations and excessive daytime sleepiness. Four years prior he underwent radiofrequency ablation after a confirmed diagnosis of AF with subsequent resolution of his palpitations. His palpitations returned approximately 1 year following the ablation. These events would occur only at night and awake him from sleep

2018 Chest

11. Usefulness of the external loop recorder in a patient with Myotonic Dystrophy type 1 and recurrent episodes of palpitations: evaluation of the follow-up from diagnosis to 6 month-post-cardiac interventional treatment Full Text available with Trip Pro

Usefulness of the external loop recorder in a patient with Myotonic Dystrophy type 1 and recurrent episodes of palpitations: evaluation of the follow-up from diagnosis to 6 month-post-cardiac interventional treatment A patient with Myotonic Dystrophy type 1 and recurrent episodes of palpitations is reported, in which the application of an external loop recorder (ELR) was useful for the diagnosis and post radiofrequency ablation follow-up of typical atrial flutter.

2018 Acta Myologica

12. Benefits of an early management of palpitations. Full Text available with Trip Pro

Benefits of an early management of palpitations. Palpitations are a frequent symptom in the general population, and if cardiac arrhythmias are the most frequent etiology, their diagnosis may be uncertain. We sought to see whether a specialized management of palpitations is associated with a high diagnostic accuracy in patients presenting with palpitations.Consecutive patients addressed for isolated palpitations in our outpatient cardiac unit were prospectively included in this observational (...) cohort study. The initial management was standardized: 12-lead electrocardiogram (ECG) as early as possible, ECG monitoring, potentially followed by an individualized management.On 688 consecutive patients prospectively included, cardiac arrhythmia as the cause of palpitations was found in 81% of cases (77% of atrial arrhythmias, 15% of junctional tachycardia, and 8% of ventricular arrhythmias). A total of 96% of diagnoses were made during initial management. Prehospital ECG (92%) and ECG

2018 Medicine

13. Comparison of a smartphone-based ECG recording system with a standard cardiac event monitor in the investigation of palpitations in children. (Abstract)

Comparison of a smartphone-based ECG recording system with a standard cardiac event monitor in the investigation of palpitations in children. The AliveCor (Kardia) monitor attaches to a smartphone and allows a single-lead ECG to be recorded during symptoms. In 2016, we introduced the use of this smartphone device for investigating palpitations, without syncope, in children. The aim of our study was to review our experience with the smartphone device, comparing it with our previous standard

2018 Archives of Disease in Childhood

14. Repetitive narrow QRS tachycardia in a 61-year-old female patient with recent palpitations Full Text available with Trip Pro

Repetitive narrow QRS tachycardia in a 61-year-old female patient with recent palpitations 29662513 2019 02 26 1671-5411 15 2 2018 Feb Journal of geriatric cardiology : JGC J Geriatr Cardiol Repetitive narrow QRS tachycardia in a 61-year-old female patient with recent palpitations. 193-198 10.11909/j.issn.1671-5411.2018.02.012 Vereckei András A 3rd Department of Medicine, Semmelweis University, Budapest, Hungary. Gellér László L Heart and Vascular Center, Semmelweis University, Budapest

2018 Journal of geriatric cardiology : JGC

15. External 30 Days Holter Usefulness in Unexplained Syncope, Palpitations and Cardioembolic Suspected Cryptogenic Stroke Study Full Text available with Trip Pro

External 30 Days Holter Usefulness in Unexplained Syncope, Palpitations and Cardioembolic Suspected Cryptogenic Stroke Study 30416571 2018 12 07 1758-3764 12 2 2017 Dec European cardiology Eur Cardiol External 30 Days Holter Usefulness in Unexplained Syncope, Palpitations and Cardioembolic Suspected Cryptogenic Stroke Study. 101 10.15420/ecr.2017:23:10 Bermúdez Míriam Garcia MG Hospital moises broggi. - sant joan despí. Ortega Diaz Antonia A Hospital moises broggi. - sant joan despí. Basiero (...) atrial fibrillation cryptogenic stroke external holter palpitations syncope 2018 11 13 6 0 2018 11 13 6 0 2018 11 13 6 1 ppublish 30416571 10.15420/ecr.2017:23:10 PMC6213234 Europace. 2014 Jun;16(6):914-22 24158255 Europace. 2016 Aug;18(8):1265-72 26519025

2017 European Cardiology Review

16. Palpitations in a 72-year-old woman. (Abstract)

Palpitations in a 72-year-old woman. A 72-year-old woman presented with an 8-year history of palpitations occurring every few weeks. They were sudden in onset, were associated with dizziness and could last for up to 2 hours. She was prescribed bisoprolol which reduced the frequency of events but did not abolish them. Baseline ECG and echocardiography were normal. She was referred for electrophysiological study. Despite initial difficulties, diagnostic catheters were placed in the right

2017 Heart

17. Palpitations and Asthenia Associated with Venlafaxine in a CYP2D6 Poor Metabolizer and CYP2C19 Intermediate Metabolizer Full Text available with Trip Pro

Palpitations and Asthenia Associated with Venlafaxine in a CYP2D6 Poor Metabolizer and CYP2C19 Intermediate Metabolizer Cardiotoxicity has been extensively reported in venlafaxine (VEN) overdoses. Asthenia is also among the common side effects described for this antidepressant. VEN is metabolized mainly by CYP2D6 and to a minor extent by CYP2C19 to the major active metabolite O-desmethylvenlafaxine (ODV). Altered pharmacokinetic parameters in patients with polymorphisms in the CYP2D6 (...) and CYP2C19 genes that result in decreased enzymatic activity have been documented. Here we describe a patient case of VEN associated palpitations and asthenia. The patient takes VEN extended release 150 mg twice daily. Genotyping confirmed the patient is a poor metabolizer for CYP2D6 and an intermediate metabolizer for CYP2C19. We propose that the palpitations and asthenia are related to sustained VEN exposure due to reduced metabolism.

2017 Case Reports in Genetics

18. Palpitations, headache and night sweats caused by a retroperitoneal mass: case report and short review Full Text available with Trip Pro

Palpitations, headache and night sweats caused by a retroperitoneal mass: case report and short review A 31-year-old West-African female attended our emergency department presenting with palpitations, headache, fatigue and night sweats during the last 2 weeks. Clinical examination revealed tachycardia and a painful, palpable infraumbilical mass. Ultrasound examination of the abdomen showed a smoothly rounded soft-tissue mass with a diameter of 5 cm. On contrast-enhanced CT, a prevertebral mass (...) with intense contrast enhancement was seen, located caudal to the aortic bifurcation. On PET-CT, there were no distant 18F-FDG-avid locoregional nodes or masses. A tumourectomy was successfully performed, during which manipulation of the retroperitoneal tumour triggered a sharp rise in blood pressure. Histological analysis confirmed the diagnosis of a paraganglioma. The clinical complaints of headache, paroxysmal palpitations and night sweats disappeared postoperatively. This case is a classic presentation

2017 BJR Case Reports

19. “Closing the loop” on palpitations. A report of unexpected communication between a loop recorder symptom marker and pacemaker Full Text available with Trip Pro

“Closing the loop” on palpitations. A report of unexpected communication between a loop recorder symptom marker and pacemaker 28840103 2019 02 26 2214-0271 3 8 2017 Aug HeartRhythm case reports HeartRhythm Case Rep "Closing the loop" on palpitations. A report of unexpected communication between a loop recorder symptom marker and pacemaker. 377-379 10.1016/j.hrcr.2017.04.003 Ketha Siva S SS Department of Cardiology, Mayo Clinic Florida, Jacksonville, Florida. Revell Rebecca N RN Department (...) of Cardiology, Mayo Clinic Florida, Jacksonville, Florida. Flipse Thomas R TR Department of Cardiology, Mayo Clinic Florida, Jacksonville, Florida. Kusumoto Fred M FM Department of Cardiology, Mayo Clinic Florida, Jacksonville, Florida. Venkatachalam K L KL Department of Cardiology, Mayo Clinic Florida, Jacksonville, Florida. eng Case Reports 2017 05 31 United States HeartRhythm Case Rep 101656239 2214-0271 Implantable loop recorder Pacemaker Palpitations Patient activator Symptom marker 2017 8 26 6 0 2017

2017 HeartRhythm Case Reports

20. Excellent symptom rhythm correlation in patients with palpitations using a novel Smartphone based event recorder Full Text available with Trip Pro

Excellent symptom rhythm correlation in patients with palpitations using a novel Smartphone based event recorder Definitive diagnosis of arrhythmia relies on "symptom-rhythm correlation" when electrocardiographic (ECG) evidence of the patient's cardiac rhythm is obtained at the time of symptoms. The AliveCor smartphone App and device (AliveCor Inc, California, USA) has recently been introduced as an easy to use cardiac event recorder. The aim of this study was to investigate whether (...) the smartphone based event recorder could be effectively used to achieve symptom rhythm correlation in unselected patients with palpitations.20 patients (13 female, mean age 35±16 years) underwent evaluation of their palpitations for 12 weeks using 2nd generation AliveCor monitors.Symptom rhythm correlation was achieved in 85% of patients with 45% detecting an arrhythmia. Of a total of 966 ECGs available for review 96% were interpretable.The novel smartphone based event recorder is an efficient tool

2017 Journal of atrial fibrillation

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