Palpitations

Palpitations is a topic covered in the Harrison's Manual of Medicine.

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Palpitations represent an intermittent or sustained awareness of the heartbeat, often described by the pt as a thumping, pounding, or fluttering sensation in the chest. The symptom may reflect a cardiac etiology, an extracardiac cause (e.g., hyperthyroidism, use of stimulants [e.g., caffeine, cocaine]), or a high catecholamine state (e.g., exercise, anxiety, pheochromocytoma). Contributory cardiac dysrhythmias include atrial or ventricular premature beats or, when sustained and regular, supraventricular or ventricular tachyarrhythmias (Chap. 123). Irregular sustained palpitations are often due to atrial fibrillation. Asking the pt to “tap out” the sense of palpitation can help distinguish regular from irregular rhythms.

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