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? »
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