Symptom Finder - Pulse Rhythm Abnormalities
PULSE RHYTHM ABNORMALITIES
Visualizing the conduction system of the heart from its beginning in the sinus node to its ends in the ventricular muscle, one can develop a list of the causes of pulse irregularities.
Sinus node: Pulse irregularities associated with this node include sinus arrhythmia and sick sinus syndrome.
Atrium: Paroxysmal atrial tachycardia, atrial premature contractions, atrial flutter, and fibrillation are brought to mind when we focus on the atrium.
Atrioventricular (A-V) node: A-V nodal rhythm and nodal tachycardia are suggested by this anatomic structure.
Bundle of His: This structure prompts the recall of first-, second-, and third-degree heart block.
Ventricular muscle: This tissue facilitates the recall of premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation.
Simply visualizing the cardiac conduction system will not help to recall the slow pulse of vasovagal syncope or parasympathomimetic drugs.
Furthermore, a method of recalling the various causes of these cardiac arrhythmias is still needed. These are considered on pages 85 through 86.
Approach to the Diagnosis
It is wise to get a cardiology consult at the outset. Routine workup includes a CBC, sedimentation rate, thyroid panel, chemistry panel, ECG, and chest x-rays. If rheumatic fever is suspected, an ASO titer or streptozyme test will be ordered. Echocardiography, bundle of His studies, and 24-hour Holter monitoring may be necessary. If a valvular lesion or coronary artery disease is suspected, cardiac catheterization and angiocardiography will be necessary.
Visualizing the conduction system of the heart from its beginning in the sinus node to its ends in the ventricular muscle, one can develop a list of the causes of pulse irregularities.
Sinus node: Pulse irregularities associated with this node include sinus arrhythmia and sick sinus syndrome.
Atrium: Paroxysmal atrial tachycardia, atrial premature contractions, atrial flutter, and fibrillation are brought to mind when we focus on the atrium.
Atrioventricular (A-V) node: A-V nodal rhythm and nodal tachycardia are suggested by this anatomic structure.
Bundle of His: This structure prompts the recall of first-, second-, and third-degree heart block.
Ventricular muscle: This tissue facilitates the recall of premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation.
Simply visualizing the cardiac conduction system will not help to recall the slow pulse of vasovagal syncope or parasympathomimetic drugs.
Furthermore, a method of recalling the various causes of these cardiac arrhythmias is still needed. These are considered on pages 85 through 86.
Approach to the Diagnosis
It is wise to get a cardiology consult at the outset. Routine workup includes a CBC, sedimentation rate, thyroid panel, chemistry panel, ECG, and chest x-rays. If rheumatic fever is suspected, an ASO titer or streptozyme test will be ordered. Echocardiography, bundle of His studies, and 24-hour Holter monitoring may be necessary. If a valvular lesion or coronary artery disease is suspected, cardiac catheterization and angiocardiography will be necessary.
