Lewalter T. [The patient with unclear palpitations: how extensive should the diagnostic approach be?].
Herzschrittmacherther Elektrophysiol 2008;
19:155-159. [PMID:
18956162 DOI:
10.1007/s00399-008-0018-1]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 07/27/2008] [Indexed: 05/27/2023]
Abstract
The symptom "palpitation" may be caused by a cardiac arrhythmia; however, in a significant number of events no concomitant arrhythmia can be documented. In addition, a patient complaining about palpitations can be threatened by an event leading to significant morbidity or even increased mortality (e.g., atrial fibrillation in a patient with risk factors for stroke) or, in contrast, the symptom palpitation may have no implications in terms of morbidity or prognosis (e.g., premature atrial contractions in a healthy person). This unspecific character of the symptom "palpitation" makes clear that the diagnostic approach has to be individualized: the patient with severe concomitant symptoms, hemodynamic deterioration and/or risk factors for cardiogenic thromboembolism should be thoroughly investigated to detect an underlying disease and to document an ECG during the palpitations. Those with only mild symptoms and no evidence for a cardiac disease in a non-invasive work-up can be simply followed-up.
Collapse