Heart Rhythm Disorders (cont.)

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When to seek medical care

Unexplained palpitations are not normal, especially when associated with shortness of breath, sweating, feelings of chest pressure, or passing out. The person should be made comfortable and laid flat, and EMS (emergency medical service) should be activated by calling 9-1-1 or the emergency number in your area.

If the person is unconscious or unresponsive, Basic life support (American Heart Association) should be initiated. Call 9-1-1, get an AED, and decide whether CPR should be initiated.

If the episode is short-lived and resolves spontaneously, the primary care professional should be contacted urgently to seek advice.

If the episode is a recurrent problem, the diagnosis is known, and the rhythm disturbance resolves itself, then a less urgent call to the primary care professional is warranted.

It is reasonable to seek emergent medical care any time that a heart rhythm disturbance occurs or if there is concern that a heart problem is present.

How are heart rhythm disorders diagnosed?

The mainstay of diagnosis remains the EKG and heart rhythm monitoring. These are often done immediately in the ambulance or upon arrival in the emergency department. In many patients, the palpitations or symptoms may have resolved, and no acute rhythm abnormalities can be found.

Depending on the associated symptoms and the history, observation and monitoring of the heart may occur in hospital or as an outpatient. In patients who have passed out, admission to the hospital often occurs. Those patients with chest pain and shortness of breath may also be admitted to evaluate their heart. In patients who are not admitted, a heart monitoring device may be placed to monitor the rhythm for a duration of time. Monitors may be worn for 24 hours or up to 1 month. In some instances, rhythm identification is elusive and may take months or years to capture and identify. Implantable cardiac monitors may be placed for periods greater than 1 year.

If the rhythm is known, then tests to identify potential causes may be done. These are dependent on the specific rhythm abnormality and can range from blood tests to lung evaluations and sleep studies to echocardiograms and electrophysiologic testing.

Medically Reviewed by a Doctor on 9/11/2013

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