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Cardiac
Arrhythmia
Cardiac arrhythmia refers to an abnormality in the
rhythm or rate of the heart.The normal heart rate
should be regular and between 60-85 beats per minute
in a state of rest.
The perception by the patient of an irregular heart
beat, or an accelerated rate are commonly referred
to as palpitations.
There are many conditions and disorders which can
cause cardiac arrhythmias, either as a primary manifestation
of a disease process, or as a secondary effect.
Causes
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Coronary Artery Disease |
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Congestive Heart Failure |
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Pericarditis |
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Myocarditis |
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Congenital Heart Disease |
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Mitral Valve Prolapse |
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Scleroderma |
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Valvular Heart Disease (e.g. aortic stenosis)
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Hyperthyroidism |
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Electrical Injury |
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Cold Injury |
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Myocardial Contusion |
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Drug Side Effects |
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Drug Toxicity (cocaine abuse) |
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Anxiety |
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Hyperventilation |
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Diabetes |
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Heart Attack |
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Pulmonary Embolism |
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Kidney Failure |
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Dehydration |
Serious Cardiac Arrythmias
Serious heart arrhythmias are often
associated with cardiac symptoms. In cases of shortness
of breath, chest pain, sweating, nausea, faintness,
or fainting associated with palpitations immediate
emergency evaluation is required.
Patients with a previous history for serious arrhythmias
or heart attack should seek immediate medical evaluation
for palpitations, even in the absence of associated
symptoms.
Hypothermia (low body temperature) patients can contract
serious cardiac arrhythmias as a complication. A cardiac
arrhythmia known as atrial fibrillation can increase
the risk of stroke, through the development of a blood
clot within the heart that is released into the general
circulation (embolization). This occurs more commonly
in the patient who suffers from intermittent atrial
fibrillation.
Benign Cardiac Arrythmias
Many people experience palpitations at one time or
another. These palpitations may be associated with
stress, anxiety, fever, alcohol use, mitral valve
prolapse, caffeine, nicotine, or decongestants (pseudo-ephedrine).
Benign arrhythmias are not
associated with the cardiac symptoms listed above.
Avoidance of all stimulants can often result in complete
resolution of symptoms.
Diagnosis
Evaluation of cardiac arrhythmias will include an
ECG and blood tests (blood chemistry, blood drug levels,
and thyroid profile). An echocardiogram may be done
to rule out the presence of valvular heart disease
or mitral valve prolapse. A 24-hour cardiac monitor
is worn by some patients to determine if a more serious
arrhythmia exists that will require treatment.
Treatment
Treatment ranges from avoidance of stimulants to placement
on antiarrhythmic medications. The Cardiologist is
the expert in the treatment and evaluation of this
problem.
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