Difference between revisions of "Palpitations"

(Text replacement - "*Troponin" to "*Troponin")
Line 4: Line 4:
 
===Red flags===
 
===Red flags===
 
*Cardiac disease
 
*Cardiac disease
*Known ECG abnormality
+
*Known [[ECG]] abnormality
 
*[[Syncope]]/pre-syncope
 
*[[Syncope]]/pre-syncope
 
*Exertional palpitations
 
*Exertional palpitations
 
*[[Hypotension]] or relative hypotension
 
*[[Hypotension]] or relative hypotension
*Heart failure symptoms
+
*[[Heart failure]] symptoms
  
 
==Clinical Features==
 
==Clinical Features==
 
*Sensation of rapid or irregular heart rate
 
*Sensation of rapid or irregular heart rate
 
*[[Syncope]] or pre-syncope
 
*[[Syncope]] or pre-syncope
*Shortness of breath
+
*[[Shortness of breath]]
*Anxiety
+
*[[Anxiety]]
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
Line 23: Line 23:
 
*[[ECG]]
 
*[[ECG]]
 
*CBC
 
*CBC
*Chem
+
*BMP
 
*TSH
 
*TSH
 
*[[CXR]]
 
*[[CXR]]
 
*[[Troponin]] in patients with suspicion for underlying heart disease or failure
 
*[[Troponin]] in patients with suspicion for underlying heart disease or failure
*Consider extended electrolytes
+
*Consider extended electrolytes (Mg/Phos)
 
*Consider toxicologic work-up if concern for intoxications
 
*Consider toxicologic work-up if concern for intoxications
  
Line 48: Line 48:
  
 
[[Category:Cardiology]]
 
[[Category:Cardiology]]
 +
[[Category:Symptoms]]

Revision as of 16:04, 25 September 2019

Background

  • Sensation of rapid or irregular heart rate

Red flags

Clinical Features

Differential Diagnosis

Palpitations

Evaluation

Work-Up

  • ECG
  • CBC
  • BMP
  • TSH
  • CXR
  • Troponin in patients with suspicion for underlying heart disease or failure
  • Consider extended electrolytes (Mg/Phos)
  • Consider toxicologic work-up if concern for intoxications

Diagnosis

  • Thyroid exam
  • Careful cardiac exam for murmurs
  • Cardiac monitoring
  • Consider walk test if palpitations primarily present with exertion

Management

  • Etiology specific

Disposition

  • Etiology specific
  • Consideration for Holter monitoring (or similar) with outpatient cardiologist if clinically stable for discharge home
  • Recommend avoidance of stimulants and alcohol pending outpatient follow-up

See Also