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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.