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Heart Rhythm Disorders (cont.)

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 laid flat, and EMS (emergency medical service) should be activated by calling 911 or the emergency number in your area. If the person is unconscious, life support should be undertaken following the American Heart Association guidelines.

If the episode is short lived and resolves spontaneously, the primary care provider 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 provider is warranted.

One should not be faulted for seeking emergent medical care any time a heart rhythm disturbance occurs.

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. Unfortunately, in many patients, the palpitations or symptoms 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 are syncopal, meaning that they passed out, and it cannot be explained by a benign diagnosis like vasovagal syncope, admission to the hospital often occurs. Those patients with chest pain and shortness of breath may also be admitted to evaluate their heart; otherwise, monitoring devices that can measure heart rates and rhythms for 24 or 48 hours or longer (up to one month or more) are used. In some instances, rhythm identification is elusive and may take months or years to capture and identify.

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 to echocardiograms and electrophysiologic testing.



Next: What is the treatment for heart rhythm disorders? »

Heart Rhythm Disorders: What Type of Disorder

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