Heart Rhythm Disorders (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- How does the heart work?
- What is a heart rhythm disorder (arrhythmia)?
- What causes heart rhythm disorders?
- What are the signs and symptoms of heart rhythm disorders?
- What are the different types of heart rhythm disorders?
- Premature atrial contractions (PACs) and premature ventricular contractions (PVCs)
- Sinus tachycardia
- Sinus bradycardia
- Abnormal heart rhythms
- Ventricular fibrillation (V-fib)
- Ventricular tachycardia (V-tach)
- Paroxysmal supraventricular tachycardia (PSVT)
- Wolff-Parkinson-White (WPW) syndrome
- Atrial fibrillation (A-fib)
- Atrial flutter
- Heart blocks
- When to seek medical care
- How are heart rhythm disorders diagnosed?
- What is the treatment for heart rhythm disorders?
- What is the prognosis for heart rhythm disorders?
- Can heart rhythm disorders be prevented?
- Find a local Cardiologist in your town
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.
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