palpitations

Problem based review: The patient with ‘palpitations’

Trainee Section, Volume 11, Issue 3, Pages 129 - 185 (2012)

Abstract

Palpitations, or the sensation of a rapid or heavy heartbeat, are a common symptom in both primary and secondary care settings. Here we use a common presentation of palpitations to explore the best ways to assess and treat patients who present in this way. We hope that by using a structured approach to our assessment we will reduce the use of the ‘scattergun’ approach to diagnosis, thus preventing unnecessary investigation and hospital stay.

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A patient with palpitations (Answers)

Picture Quiz, Volume 13, Issue 4, Pages 149 - 194 (2014)

Discussion

Ventricular tachycardias represent an important cause of palpitations. The differentiation of “benign” or “idiopathic” ventricular tachycardias from those which require more aggressive pharmacological and device therapy is an important diagnostic step and requires careful history taking, clinical examination and ultrasound evaluation of both left and right ventricular function.

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A patient with palpitations

Picture Quiz, Volume 13, Issue 4, Pages 149 - 194 (2014)

Case Report

A 52 year old woman presented to the Acute Medical Unit with her 4th episode of palpitations in the past four weeks. Each episode was similar in nature and described as being acute in onset, fast and regular, associated with pre-syncope but never syncope or chest pain. The episodes lasted for 30 – 45 minutes and would self terminate. Of particular note, the episodes were not associated with exertion and she had a normal exercise tolerance.

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Problem based review: The Pregnant Woman Presenting to the AMU with Palpitations

Trainee Section, Volume 13, Issue 3, Pages 101 - 148 (2014)

Abstract

Pregnant patients commonly present to the acute medical team with symptoms requiring further investigation. Palpitations are a common reason for presentation on the acute medical take, and most acute physicians will be familiar with the process of investigation. The combination of pregnancy and palpitations raises a broad differential diagnosis and can complicate the management pathway. This problem based review is designed to summarise the key issues which may arise during the management of a typical patient presenting in this way.

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