Physical examination

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Cardiovascular medicine

Palpitations

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During an episode of palpitations observe the following:

co-ordination of atrial and ventricular contraction

The following is a summary of the physical findings for the major arrhythmias:



AF - bp variable, heart sounds variable, arterial pulse - irregular, jugular pulsation - absent

AVNT - bp - fixed, heart sounds - fixed, arterial pulse - regular, jugular pulsation - neck+

CMT/AT - bp - fixed, heart sounds - fixed, arterial pulse - regular, jugular pulsation - neck-

VT - bp - variable, heart sounds - variable, arterial pulse - regular, jugular pulsation - canon waves

(AF = atrial fibrillation, AVNT = atrioventricular nodal tachycardia, CMT = circus movement tachycardia, AT = atrial tachycardia, VT = ventricular tachycardia, neck+ = palp- itation felt in neck as well as chest, neck- = palpitation felt only in chest).

Patients examined when the palpitations have subsided are invariably normal (except for the signs of any underlying heart disease).

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Physical examination

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