Palpitations with abnormal heart rate
Introduction
Introduction Palpitation is a sense of discomfort or palpitation that consciously beats the heart. When the heart rate is increased, it is felt that the heart beats discomfort, and when the heart rate is slow, it feels powerful. When you have a heart palpitations, your heart rate can be fast, slow, or have arrhythmia. People with normal heart rate and heart rhythm can also have heart.
Cause
Cause
(1) tachycardia
Sinus tachycardia, tachycardia atrial fibrillation or atrial flutter caused by various reasons, especially those who suddenly occur, are easy to cause palpitations.
(2) bradycardia
High atrioventricular block, atrioventricular junction rhythm, spontaneous ventricular rhythm, sick sinus syndrome, vagus nerve excitability, etc., due to slow heart rate, prolonged diastolic phase, increased ventricular filling, and strong heart beat Powerful, can cause heart palpitations. But my heart is more common when my heart rate suddenly slows down.
(3) Arrhythmia
Such as premature beats (pre-systolic), atrial fibrillation, etc., can cause heart palpitations. Sporadic premature beats usually do not cause symptoms, but patients may feel guilty because of a sudden heartbeat, and sometimes a sudden stop of the heart (compensatory pause).
Examine
an examination
Related inspection
Friedrich's electrocardiogram free triiodothyronine (FT3) cerebrospinal fluid sodium free triiodothyronine
(1) heart rate with heart rate greater than 100 beats / min
When a heart palpitus occurs, the patient can self-test the pulse. If the heart rate is greater than 100 beats per minute, the palpitations caused by tachycardia should be considered.
(2) heart rate with heart rate less than 60 beats / min
When a heart palpitus occurs, the patient self-tests the pulse and the heart rate is less than 60 beats per minute. The palpitations caused by bradycardia should be considered.
(3) Clinically, a 12-lead ECG is used. The nature and location of the heart can be judged from the perspective of the three-dimensional structure of the heart. Clinically, P-waves clearly lead (II, III, aVF, and V1 leads) for longer time tracing, which is more helpful in capturing the occurrence of heart rhythm abnormalities.
Diagnosis
Differential diagnosis
1, when you have a heartbeat with a heartbeat
When the heart is palpitative, the patient self-tests the pulse. If the heartbeat is irregular, there is a stop, and the heart may be related to the arrhythmia.
2, palpitations with neurosis
More common in patients with cardiac neurosis, patients are more common in young women. In addition to heart palpitations, patients often have rapid heartbeat, chest tightness, tingling or dull pain in the precordial area, and poor breathing. And often accompanied by headache, dizziness, insomnia, fatigue, inattention and other symptoms of neurosis. The onset is often associated with mental factors, each with an emotional excitement.
3, heart palpitations with hypertension
If you have a history of hypertension, palpitations, dizziness, headache, high blood pressure, you should consider the heart palpitations caused by hypertensive heart disease. If there is no history of hypertension, paroxysmal blood pressure is elevated, and palpitations are associated with pheochromocytoma.
4, heart palpitations with weight loss, diarrhea, irritability and irritability
The heart palpitations are accompanied by weight loss, polyphagia, frequent bowel movements, bulging eyeballs, and irritability. The heart palpitations caused by hyperthyroidism should be considered.
5, palpitations with fatigue, pale
The heart is accompanied by fatigue, pale, dizziness, and low hemoglobin. The palpitations caused by anemia should be considered.
6, heart palpitations appear 3 hours after a meal
The heart palpitations appear 3 hours after a meal or on an empty stomach. With dizziness, hunger, and cold sweat, hypoglycemia should be considered. For those with diabetes or insulin therapy, attention should be paid to hypoglycemia caused by overdose.
7, fever, sore throat, chest tightness, heart palpitations
First, fever, sore throat and other symptoms, chest tightness, chest pain, palpitations after 3 weeks, should consider myocarditis. More common in young people. The above discussion of physiological palpitations, pathological palpitations, and inferring the etiology of palpitations from concomitant symptoms of palpitations. Clinically, patients need to be aware that palpitations are related to the patient's mental factors and attention. Physically and mentally healthy people do not feel that their hearts are beating in a quiet state, but they are often stunned after emotional or strong physical activity. However, for a short time, restless moments disappeared. The nervous person is not the same, the general heart rate suddenly increased or occasionally premature beats can also feel guilty. In addition, when the patient is focused, such as before going to bed at night, or in a gloomy environment, palpitations are often prone to appear. It is particularly noteworthy that many patients with chronic arrhythmias, due to their gradual adaptation, often do not feel obvious palpitations, and are prone to delay in treatment. At this point, self-testing pulse beat is necessary. Be careful to skip faster (more than 60 A points), slow heartbeat (less than 100 A points), and when there is a sudden heartbeat, you should go to the hospital in time. In addition, when the patient feels guilty and concludes the general cause according to the accompanying symptoms, he should also go to the hospital for various examinations in time to confirm the diagnosis and timely treatment.
