Palpitation心悸

Palpitation,Definition,Palpitation may be defined as an awareness of the beating of the heart, an awareness commonly brought about by a change in the hearts rhythm or rate or by an augmentation of its contractility.,Definition,Palpitation does not means heart disease.The degree of palpitation is not equal to the severity of heart disease.Patients with anxiety states often exhibit a lowered threshold at which disorders of rate and rhythm result in palpitation.,Definition,Persistent tachycardia and/or atrial fibrillation(心房颤动) may not be accompanied by continual palpitation.A sudden, brief alteration in cardiac rate or rhythm which often causes considerable subjective discomfort.,Etiology,Augmentation of heart contractilityArrhythmia(心律失常)Cardiac neurosis(心脏神经官能症),Augmentation of heart contractility,Physiological augmentationPathological augmentation,Physiological augmentation,Exercising strongly and overnervousAfter drinking coffee, tea, alcoholTaking medicine such as ephedrine(麻黄素), aminophylline(氨茶碱), atropin(阿托品) etc.,Pathological augmentation,Ventricular hypertrophy: such as hypertensive heart disease, valvular insufficiency(瓣膜关闭不全), patent ductus arterious (PDA动脉导管为闭), ventricular septal defect (VSD室缺) etc. Heart preload or afterload increase hypertrophy augmentation of contractility palpitation,Pathological augmentation,Other diseases which increase cardiac output:Thyrotoxicosis(甲亢): basic metabolism amplify & sympathetic nerve exciteheart ratesAnemia(贫血): hypoxaemia heart rates mild, chronic anemia may cause palpitation during exertion. severe, acute anemia may cause palpitation at rest.,Fever: basic metabolism amplify Hypoglycemia(低血糖): Palpitation is often a prominent feature of the condition and appears to be release of catecholamine(儿茶酚胺).,Arrhythmia,Tachycardia: sinus, supraventricular, ventricularBradycardia: SSS, AVB, sinus bradycardia diastolic period prolong EDV augmentation of heart contractilityArrhythmia: premature beat, atrial fibrillation irregular beat or long course,Cardiac neurosis,Turbulence of sympathetic nerve & pneumogastric nerveVarious symptom: palpitation, chest pain, tire, insomnia(失眠), headache, dizziness(眩晕) etcUsually seen in femaleInducement: anxiety, excitementDiagnosis: cautious,Accompanying symptoms,Palpitation with chest pain. It is often present in coronary heart disease (angina心绞痛, myocardial infarction), myocarditis(心肌炎), pericarditis(心包炎). It is also present in cardiac neurosis.,Accompanying symptoms,Palpitation with fever. It is observed in acute infection, rheumatic fever(风湿热), myocarditis, pericarditis, infective endocarditis(感染性心内膜炎).,Accompanying symptoms,Palpitation with syncope(晕厥) or twitch(抽搐). It is present in high-degree AVB, ventricular fibrillation(室颤), paroxysmal ventricular tachycardia, SSS.,Accompanying symptoms,Palpitation with anemia. It happens after acute hemorrhage, which accompanys with sweat, hypotension, shock. Palpitation with weight loss and sweating. It suggests Thyrotoxicosis.,小结,心悸的病因心脏搏动增强心律失常心脏神经官能症,心脏搏动增强的原因生理性者 剧烈运动、过度紧张、烈性饮料、药物病理性者 心室肥大、甲亢、贫血、发热、低血糖,心律失常引起心悸的原因心率快心率慢心脏搏动不规则,复习思考题,不是心悸原因的是A.心肌收缩力减弱B.心动过速C.心动缓慢D.期前收缩E.心房颤动,引起心悸的病理因素是A.应用阿托品B.饮酒和喝浓茶、咖啡后C.精神过度紧张D.甲状腺功能亢进E.以上都不是,关于心悸不正确的是A.是自觉心脏跳动的不适感或心慌感B.有心悸则一定有心脏病C.心动过速或心动过缓均可引起心悸D.自主神经功能紊乱可引起心悸E.生理情况下也可出现心悸,X型题,引起心悸的左心室肥大性疾病有A.高血压性心脏病B.主动脉瓣关闭不全C.二尖瓣关闭不全D.期前收缩