Physical diagnosis Palpitation 水
Physical Diagnosis Palpitation
Introduction Palpitation is an unpleasant awareness of the heart beating, not necessary associated with organic heart sease Mechanism Heart contractility: Augmentation Heart rhythm: Regular Irregular Heart rate: normal> fast or slow
Introduction Palpitation is an unpleasant awareness of the heart beating, Not necessary associated with organic heart disease. Mechanism Heart contractility: Augmentation Heart rhythm: Regular Irregular Heart rate: Normal fast or slow
Etiology I. Forceful Contraction of Heart 1. Physiological type strenuous physical effort sudden emotional tension use of coffee. tea. alcohol. tobacco and some rugs Pathological type 1). Ventricular hypertrophy Hypertensive heart disease Rheumatic heart disease 2) Disorders causing augmentation of cardiac output Anemia, High fever, Hyperthyroidism Hypoglycemia, Pheochromocytoma
Etiology I. Forceful Contraction of Heart 1. Physiological type — strenuous physical effort — sudden emotional tension, — use of coffee, tea, alcohol, tobacco and some drugs 2. Pathological type 1). Ventricular hypertrophy — Hypertensive heart disease, — Rheumatic heart disease, 2). Disorders causing augmentation of cardiac output — Anemia, High fever, Hyperthyroidism, Hypoglycemia, Pheochromocytoma
II. Cardiac arrhythmias Tachycardia: tachyarrhythmia paroxysmal tacycardia atrial flutter atrial fibrillation. 2. Bradycardia: bradyarrhythmia high degree av block SICK Sinus syndrome and so on O 3. Premature beat of heart I. Cardiac neurosis Disturbance of autonomic nervous system, and no organic lesion in heart, Chief symptoms are palpitation and those of anxiety state Menopausal Syndrome yndrome of increased B-adrenergic receptor responsiveness
II. Cardiac arrhythmias. 1.Tachycardia: tachyarrhythmia — paroxysmal tacycardia, — atrial flutter, — atrial fibrillation, 2. Bradycardia: bradyarrhythmia — high degree AV block, — sick sinus syndrome and so on. 3. Premature beat of heart III. Cardiac neurosis Disturbance of autonomic nervous system, and no organic lesion in heart, Chief symptoms are palpitation and those of anxiety state. — Menopausal syndrome, — Syndrome of increased -adrenergic receptor responsiveness
Approach to Patients with Palpitation History 1. Use of coffee, tabacco, alcohol, drugs etc 2. Onset and duration of palpitation 3. Anxiety state 4. Accompanied symptoms Precordial pain Organic heart disease or Cardiac neurosis Anemia or fever: may be the cause of palpitation +Weight loss, sweating Hyperthyroidism
Approach to Patients with Palpitation History 1. Use of coffee, tabacco, alcohol, drugs etc; 2. Onset and duration of palpitation; 3. Anxiety state; 4. Accompanied symptoms + Precordial pain: Organic heart disease or Cardiac neurosis + Anemia or fever: may be the cause of palpitation + Weight loss, sweating : Hyperthyroidism