Harrison’s Manual of Medicine 19th edition provides 600+ internal medicine topics in a rapid-access format. Download Harrison’s App to iPhone, iPad, and Android smartphone and tablet. Explore these free sample topics:
-- The first section of this topic is shown below --
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.