Last reviewed: September 2018
Last updated: October  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of valvular heart disease, coronary artery disease, hypertension, pericarditis, cardiomyopathy, and other arrhythmias
  • presence of diabetes mellitus, thyroid disease, alcohol abuse, and cancer
  • palpitations
  • tachycardia
  • irregular pulse

Other diagnostic factors

  • stroke
  • shortness of breath
  • fatigue
  • chest pain
  • dizziness
  • asymptomatic
  • hypotension
  • elevated JVP
  • murmur or gallop rhythm
  • rales
  • decrease in mentation or listlessness

Risk factors

  • hypertension
  • coronary artery disease
  • congestive heart failure
  • advancing age
  • diabetes mellitus
  • rheumatic valvular disease
  • alcohol abuse
  • male sex
  • presence of other arrhythmias
  • smoking
  • thyroid disease
  • autonomic neuronal dysfunction
  • obesity and obstructive sleep apnea (OSA)
  • caffeine abuse
  • cancer

Diagnostic investigations

1st investigations to order

  • 12-lead ECG
  • thyroid profile
  • echocardiogram
  • serum electrolytes (including serum magnesium) and BUN
Full details

Investigations to consider

  • serum aminotransferases
  • prolonged ECG monitoring
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Medicine

Mount Sinai School of Medicine

New York

NY

Disclosures

ANS declares that she has no competing interests.

President, Cardiovascular and Heart Rhythm Consultants

Clinical Professor of Medicine

Icahn School of Medicine at Mount Sinai

Attending and Consultant Cardiac Electrophysiologist

Mount Sinai and New York Presbyterian Hospitals

New York

NY

Disclosures

BKK declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Cardiologist

Jersey General Hospital

St Helier

Jersey

Channel Islands

Disclosures

ARJM declares that he has no competing interests.

Professor of Medicine (Cardiology)

Westchester Medical Center

Valhalla

NY

Disclosures

DJ declares that he has no competing interests.

Associate Professor

Department of Cardiothoracic Surgery

Mount Sinai Medical Center

New York

NY

Disclosures

KP declares that he has no competing interests.

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