These days medical students are just flooded with a huge amount of information –different description of diseases, fresher and fresher publications – available online. It is really difficult to pick the clinically relevant data, especially when you do not have those years of practice behind your back. In our blog series You will find short and straightforward lists of clinical signs, symptoms which are the most typical and pathognomonic in certain diseases.
From 4-10 June 2018, the World Heart Rhythm Week takes place all over the world. Naturally, we felt like arrhythmia is a crucial topic to cover. There are of course countless different types of arrhythmias with specific (or even with no) clinical signs; however, we decided to focus on the general symptoms. Remember, if any of these are present, arrhythmias should be one of the differential diagnostical choices.
Why? When the heart cannot pump blood effectively during excessively fast (tachycardia) or slow (bradycardia) heart rates, the amount of blood that reaches the brain is reduced. If the arrhythmia causes such a significant drop in the blood pressure, then the brain does not receive enough blood to keep the patient conscious. Sometimes, this can be the only sign of arrhythmias.
Why? It’s basically the same reason as written above, only a less dramatic manifestation.
Why? Arrhythmias make patient unusually aware of their heartbeat. The experience of palpitations is often described differently by different people: fluttering or feeling a skipped beat for example. Others note a pounding sensation or feel that the heart is jumping out of their chest. The pattern and characteristics of the palpitations can be helpful in determining the type of arrhythmia.
Why? Some people might experience various arrhythmias not as palpitations but rather as chest pain. In people who have healthy hearts, palpitations can cause a pounding or thumping sensation that can be painful or uncomfortable. In people who have coronary artery disease, a rapid heart rate can cause angina.
Why? Patients may experience dyspnea when the pump function of the heart is damaged because of certain types of arrhythmia. Specifically, there may not be enough time between heartbeats for the left ventricle to fill with blood, causing blood to back up into the lungs. The increased pressure and fluid in the lungs results in shortness of breath.
Why? And yet again, during arrhythmias, pump function is compromised - the muscles and the whole body won’t get enough blood, therefore oxygen. That is the reason behind fatigue and weakness.
Why? During different arrhythmias, the sympathetic nervous system is activated, and as we all know from our exam situations, sweating naturally comes with this activation.
After learning the basics, test your knowledge in practice by solving the MS Day Challenge in InSimu Patient app! You can download it for iOS or Android.