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Physiology Cardiac Arrhythmias
Cardiac arrhythmia refers to an abnormality in the rhythm or rate of the heart. The normal heart rate should be regular and between 60-85 beats per minute in a state of rest. The perception by the patient of an irregular heart beat, or an accelerated rate are commonly referred to as palpitations. Cardiac arrhythmias are divided into two categories: SERIOUS and BENIGN.
SERIOUS CARDIAC ARRHYTHMIAS
SERIOUS heart arrhythmias are OFTEN associated with cardiac symptoms. In cases of shortness of breath, chest pain, sweating, nausea, faintness, or fainting associated with palpitations immediate EMERGENCY evaluation is required. Drug toxicity or unwanted drug side effects can occasionally cause SERIOUS cardiac arrhythmias. Cocaine abuse can also result in serious arrhythmias. Patients with a previous history for serious arrhythmias or heart attack should seek immediate medical evaluation for palpitations, even in the absence of associated symptoms. Hypothermia (low body temperature) patients can contract serious cardiac arrhythmias as a complication. Serious cardiac arrhythmias can also be associated with myocardial contusion. A cardiac arrhythmia known as atrial fibrillation can increase the risk of stroke, through the development of a blood clot within the heart that is released into the general circulation (embolization). This occurs more commonly in the patient who suffers from intermittent atrial fibrillation.
BENIGN CARDIAC ARRHYTHMIAS
Many people experience palpitations at one time or another. These palpitations may be associated with stress, anxiety, fever, alcohol use, mitral valve prolapse, caffeine, nicotine, or decongestants (pseudoephedrine). BENIGN arrhythmias ARE NOT associated with the cardiac symptoms listed above. Avoidance of all stimulants can often result in complete resolution of symptoms. Follow-up with your physician is recommended. Evaluation of cardiac arrhythmias will include an EKG and blood tests (blood chemistry, blood drug levels, and thyroid profile). Echocardiogram may be done to rule out the presence of valvular heart disease or mitral valve prolapse. A 24-hour cardiac monitor is worn by some patients to determine if a more serious arrhythmia exists that will require treatment. Treatment ranges from avoidance of stimulants to placement on antiarrhythmic medications. The Cardiologist is the expert in the treatment and evaluation of this problem.
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