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Previous Volume 338:1369-1373 May 7, 1998 Number 19 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Palpitations are one of the most common problems of outpatients who present to internists and cardiologists. Although usually benign, they are occasionally a manifestation of potentially life-threatening conditions. The physician's fear of missing a treatable condition may lead to the inappropriate use of expensive tests with little diagnostic and therapeutic value. The following discussion will describe the common presentations of palpitations and offer a guide to rational diagnostic testing.

Common Presentations: Symptoms and Associated Circumstances

Symptoms

Palpitations are described in a myriad of ways, but some specific symptoms are common and useful for narrowing the differential diagnosis.

            Flip-Flopping in the Chest

The heart seems to stop and then start again, producing . . . [Full Text of this Article]

            Rapid Fluttering in the Chest

            Pounding in the Neck

Circumstances

            Palpitations Associated with Anxiety or Panic Reactions

            Palpitations during Periods of Catecholamine Excess

            Palpitations Associated with Position

            Palpitations Associated with Syncope or Near-Syncope

Diagnostic Evaluation

Physical Examination

Twelve-Lead Electrocardiography

Diagnostic Testing

Ambulatory Monitoring Devices

Management

Source Information

From the Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston.

Address reprint requests to Dr. Zimetbaum at the Cardiovascular Division (GZ-435), Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.

References

This article has been cited by other articles:

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