The Rational Clinical Examination
David L. Simel, Drummond Rennie
David L. Simel
Make the Diagnosis: Does This Patient With Palpitations Have a Cardiac Arrhythmia?
cardiac arrhythmia, criterion standard comparisons (diagnostic tests), holter electrocardiography, likelihood ratio, make the diagnosis, palpitations
"About 16% of general medical patients report that they
have palpitations.1 Within this group of symptomatic
patients, the pretest probability of any cardiac arrhythmia is 39%.
Important risk factors are age, sex, family history of palpitations,
history of panic disorder, and history of prior cardiac disease.
Medications should be reviewed for all patients with palpitations.
Having the patient tap out his or her perceived rhythm or to choose
from cadences tapped out by the physician may help in identifying
the regularity and speed of the palpitations...."
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