The Rational Clinical Examination
David L. Simel, Drummond Rennie
Cardiac Arrhythmia
Paaladinesh Thavendiranathan, Akshay Bagai, Clarence Khoo, Paul Dorian, Niteesh K. Choudhry
Sections:
Clinical Scenario, Why Is the Clinical Examination for Palpitations Important?, How to Evaluate a Patient With Palpitations, Methods, Results, Limitations of Published Studies, Scenario Resolution, Bottom Line, References
Topics Discussed:
cardiac arrhythmia
Excerpt:
"A 58-year-old woman presents to the emergency department with
intermittent episodes of palpitations. She describes "heart
fluttering" that usually lasts less than 5 minutes, which
is associated with a sense of "impending doom," sweating,
and paresthesia in both hands. She is unable to tell whether the
rhythm is regular or irregular and denies a regular rapid-pounding
sensation in the neck. There is no associated presyncope or syncope.
She has a history of panic disorder but is otherwise healthy and
takes no medications. Her pulse rate and rhythm are palpably normal
and the rest of her physical examination along with a 12-lead electrocardiogram
is normal...."
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