tachycardia

Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients

Original Articles, Volume 18, Issue 3, Pages 137 – 204 (2019)

Background: The relationship between increase in body temperature, heart rate, and respiratory rate has only been studied in young, healthy subjects.

Aim: To show the changes in heart and respiratory rate associated with fever in acutely admitted medical patients.

Design: A prospective observational cohort study

Methods: Vital parameters from 4,493 patients were retrospectively extracted. Linear and multiple variable regression analysis was used to calculate the change in heart and temperature rate for every degree rise in temperature (i.e. ΔHR/°C and ΔRR/°C) in the entire study group and in those with low (<36.1°C), normal (36.1-38°C) and high (>38°C) body temperatures.

Results: The ΔHR/°C and ΔRR/°C was 7.2±0.4 beats per minute (bpm) and 1.4 ±0.1 (1.2 to 1.62) breaths per minute (bpm). Adjusting for age, oxygen saturation and mean blood pressure, the results were 6.4±0.4 (5.7 to 7.1) bpm and 1.2±0.1 (1.0 to 1.4) bpm. In low, normal and high body temperature the ΔHR/°C were 2.7±1.9, 6.9±1.9 and 7.4±0.9 bpm, respectively; for ΔRR/°C the values were -0.5±0.5, 1.5±0.5 and 2.3±0.3 bpm, respectively.

Conclusions: We only found a modest association between fever and changes in heart rate and respiratory rate.

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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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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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A Case of Postural Orthostatic Tachycardia Syndrome on the Acute Medical Unit

Case Reports, Volume 8, Issue 1, Pages 1 - 52 (2009)

Abstract

We describe a case of postural orthostatic tachycardia syndrome (POTS) in a young female, presenting several weeks after neurosurgery, to the Medical Admissions Unit. The diagnosis is discussed with reference to differential diagnosis, diagnostic criteria, pathophysiology and treatment.

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