Palpitations Because anxiety is the common cause of palpitations, there is a tremendous temptation to jump to this conclusion as the cause

in an otherwise healthy-looking individual. If we use the mnemonic VINDICATE, we may avoid a misdiagnosis in many cases.
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Vâ¼´Vascular causes help to recall aortic aneurysms, arterio venous fistulas, anemia, postural hypotension, migraine, and cardiac disorders such as aortic regurgitation, aortic stenosis, tricuspid insufficiency, CHF, and various arrhythmias (see page 77). Iâ¼´Inflammation reminds us of fever, pericarditis, subacute bacterial endocarditis (SBE), and rheumatic fever. Nâ¼´Neoplasms are not usually associated with palpitations. Dâ¼´Deficiency of thiamine can lead to beriberi heart disease resulting in palpitations. Iâ¼´Intoxication prompts us to recall that alcohol, tobacco, coffee, soft drinks, and tea can cause palpitations. It should also remind us that palpitations are common side effects of many drugs, including digitalis, aminophylline, sympathomimetics, ganglionic blocking agents, nitrates, and other drugs. Câ¼´Congenital disorders that may cause palpitations include patent ductus, ventricular septal defect, and hiatal hernia. Aâ¼´Anxiety is a common cause of palpitations. Tâ¼´Trauma causes palpitations by inducing the release of epinephrine, but there is no diagnostic dilemma in these cases. Eâ¼´Endocrine disorders that cause palpitations include thyrotoxicosis, pheochromocytoma, menopausal syndrome, and hypoglycemia.

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