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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 5. Alterations in Circulatory and Respiratory Functions > |
Chapter 37. Palpitations
Sections: Palpitations: Introduction, Further Readings.
Topics Discussed: palpitations.
Excerpt:"Palpitations are extremely common among patients who present to their internist and can best be defined as an intermittent "thumping," "pounding," or "fluttering" sensation in the chest. This sensation can be either intermittent or sustained and either regular or irregular. Most patients interpret palpitations as an unusual awareness of the heartbeat, and become especially concerned when they sense that they have had "skipped" or "missing" heartbeats. Palpitations are often noted when the patient is quietly resting, during which time other stimuli are minimal. Palpitations that are positional generally reflect a structural process within (e.g., atrial myxoma) or adjacent to (e.g., mediastinal mass) the heart.The principal goal in assessing patients with palpitations is to determine if the symptom is caused by a life-threatening arrhythmia. Patients with preexisting coronary artery disease (CAD) or risk factors for CAD are at greatest risk for ventricular arrhythmias as a cause for palpitations. In addition, the association of palpitations with other symptoms suggesting hemodynamic compromise, including syncope or lightheadedness, supports this diagnosis. Palpitations caused by sustained tachyarrhythmias in patients with CAD..."
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