Dec 15, 2017 Issue
Palpitations: Evaluation in the Primary Care Setting [Article]

Distinguishing cardiac from noncardiac causes is important because of the risk of sudden death in those with an underlying cardiac condition. Learn which clinical clues signal a benign cause of palpitations, and which ones suggest a more worrisome cause.

Nov 1, 2015 Issue
Diagnosis and Management of Common Types of Supraventricular Tachycardia [Article]

Sudden onset of an accelerated heart rate can cause palpitations, light-headedness, chest discomfort, anxiety, dyspnea, or fatigue. Learn the history and physical examination clues that can narrow the diagnosis and help determine an appropriate approach to treatment.

Dec 15, 2014 Issue
Abnormal Electrocardiogram Findings During an Occupational Physical Examination [Photo Quiz]

A 27-year-old man with normal personal and family histories presented for an occupational physical examination. On cardiac examination, he had a grade II/VI systolic ejection murmur that was softer during inspiration. An electrocardiogram was obtained.

Feb 15, 2014 Issue
Common Questions About Pacemakers [Article]

Pacemakers are indicated in patients with certain symptomatic bradyarrhythmias caused by sinus node dysfunction, and in those with frequent, prolonged sinus pauses. Patients with third-degree or complete atrioventricular (AV) block benefit from pacemaker placement, as do those with type II second-de...

May 15, 2013 Issue
Sick Sinus Syndrome: A Review [Article]

Sick sinus syndrome refers to a collection of disorders marked by the heart’s inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. At least 50 p...

Sep 15, 2012 Issue
Evaluation of Asymptomatic Atrial Fibrillation [FPIN's Clinical Inquiries]

In hemodynamically stable patients without acute chest pain, the evaluation and treatment of atrial fibrillation should not change based on symptoms alone.

Jul 1, 2011 Issue
Outpatient Approach to Palpitations [Article]

Palpitations are a common problem seen in family medicine; most are of cardiac origin, although an underlying psychiatric disorder, such as anxiety, is also common. Even if a psychiatric comorbidity does exist, it should not be assumed that palpitations are of a noncardiac etiology. Discerning cardi...

Jan 1, 2011 Issue
Atrial Fibrillation: Diagnosis and Treatment [Article]

Atrial fibrillation is the most common cardiac arrhythmia. It impairs cardiac function and increases the risk of stroke. The incidence of atrial fibrillation increases with age. Key treatment issues include deciding when to restore normal sinus rhythm, when to control rate only, and how to prevent t...

Oct 15, 2010 Issue
Common Types of Supraventricular Tachycardia: Diagnosis and Management [Article]

The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing accelerated heart rates. Symptoms may include palpitations (pulsation in the neck), chest pain, lightheadedness or dizziness, and dyspnea. It is unusual for supraventricular tachycardia to be caused by...

Nov 15, 2009 Issue
Catheter Ablation of Supraventricular Arrhythmias and Atrial Fibrilation [Article]

Supraventricular arrhythmias and atrial fibrillation are common and persistent cardiac rhythm disturbances. Catheter-based ablation is an effective therapy that has durable therapeutic end points and a low complication rate.

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