Professional Documents
Culture Documents
Dr POLAMURI TABITHA
PG FIRST YR
DEFINITION
CARDIAC PSYCHIATRI
C
43% 31%
MISCELLANEOU UNKNOWN
S
10% 16%
Cardiovascular Causes
Arrhythmias
Premature atrial and ventricular
contractions
Supraventicular and ventricular
arrhythmias
WPW syndrome
Atrial fibrillation
Atrial flutter with varying block
Brady-arrhythmias : complete heart block
Sick-sinus syndrome
Non-arrhythmic cardiac
causes
Mitral valve prolapse (with or without
associated arrhythmias)
Aortic insufficiency
Atrial myxoma
Pulmonary embolism
Congenital heart ds
Systemic hypertension
Pericarditis
Pacemaker induced tachycardia
Psychiatric Causes
Panic attacks
Anxiety states
Somatization
Is heart beat
regular ?
YES
NO
Are there any discrete attacks of
tachycardia >120/min Irregular heart beat
YES NO
Ectopic beats
SVT Sinus tachycardia AF
VT High stroke volume
Physical examination
Key features of physical examination
that will help confirm the presence of
arrhythmia as a cause for the
palpitations include
Measurement of vital signs
Assessment of the jugular venous
pressure and pulse
Auscultation of the chest and
precordium
INVESTIGATIONS
A resting ECG
If exertion is known to induce arrhythmia
and accompanying palpitations ,
exercise ECG is useful
2D-ECHO
1. Re-assurance
2. Lifestyle modification
3. Correction of co-morbid diseases
4. Anxiolytics and Beta-blockers
5. Anti-arrhythmic drugs / electrical
conversion