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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Cardiac Arrhythmia
Paaladinesh Thavendiranathan, Akshay Bagai, Clarence Khoo, Paul Dorian, Niteesh K. Choudhry
Box 74-1 Differential Diagnosis of Palpitations


Topics Discussed: algorithm, cardiac arrhythmia, criterion standard comparisons (diagnostic tests), diagnostic process, tachycardia

Excerpt: "Palpitations are a common, unpleasant, and often alarming awareness of heartbeats,1 with a prevalence as high as 16% in medical outpatients.2 They often pose a clinical challenge3 because of the wide differential diagnosis (Box 74-1). Palpitations may occur due to a change or abnormality in heart rhythm, such as an arrhythmia (ie, an abnormal, disordered, or disorganized heartbeat), due to an appropriate increase in normal sinus rate, or with a normal sinus rate and rhythm due to heightened sensitivity and perception of one's heartbeats (Supplemental Figure 1)...."
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