Підозрілі дані анамнезу в пацієнтів із посиленим серцебиттям
Finding | Possible Cause |
|---|---|
Occasional skipped beats | |
Rapid, regular palpitations with sudden onset and termination Often history of recurrence | PSVT, atrial flutter with 2:1 atrioventricular block, VT |
Syncope following palpitations | Sinus node dysfunction, atrioventricular bypass tract (such as in Wolff-Parkinson-White syndrome), congenital long QT syndrome, VT, atrial fibrillation, atrial flutter |
Palpitations during exercise or an emotional episode | Sinus tachycardia (particularly in healthy people) Ventricular arrhythmia from exercise-induced ischemia (particularly in people with congenital arrhythmic disorders or CAD) |
Palpitations following episodic* drug use | Drug-induced cause |
Sense of doom, anxiety, or panic | Suggests (but does not confirm) a psychological factor |
Recent surgery (postoperative period) | Sinus tachycardia (eg, due to infection, bleeding, pulmonary embolism, pain), atrial fibrillation, atrial flutter |
Recurrent episodes since childhood | Supraventricular arrhythmia (eg, atrioventricular nodal reentrant bypass tract, Wolff-Parkinson-White syndrome) Congenital long QT syndrome (usually manifests during adolescence) |
Family history of syncope or sudden death | Brugada syndrome, congenital long QT syndrome, inherited dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or hypertrophic cardiomyopathy |
* The role of regular use of drugs (particularly medications) or substances (eg, daily caffeine) can be hard to determine; sometimes a trial of withdrawal is diagnostic. All drugs with cardiovascular effects, most psychoactive drugs, and drugs capable of causing hypokalemia or hypomagnesemia must be suspected. | |
CAD = coronary artery disease; PACs = premature atrial contractions; PSVT = paroxysmal supraventricular tachycardia; PVCs = premature ventricular contractions; VT = ventricular tachycardia. | |