CBL Case 1

Question 1

What do you ask when someone thinks they are having palpitations?

Answer 1

• Rate
• Rhythm
• Character
• Tap it out

Question 2

What could cause a 62 year old company director have heart palpitations?

Answer 2

• Being an alcoholic alcohol causes AF
• Drugs

Question 3

What can heart palpitations be caused by?

Answer 3

• Medications
• Drugs
• Anti-depressants
• Caffeine (yet no actual evidence)
• Stress
• Smoking
• Electrolyte imbalance → due to: diarrhoea, diuretics, bulimia (e.g. leading to hyp_o_kalaemia → heart problems)
• Family history of heart condition
• Sepsis/infection → causes tachycardia (& vasodilation)
• SA node disease (problem with the conduction system in the heart)
• Thyroid disease (e.g. thyrotoxicosis, hyp_o_thyroidism)

Question 4

What signs can someone with heart palpitations present with?

Answer 4

• Cyanosis
• Hypoxia
• LOW BP (as if goes on for too long then, LESS ventricular filling time thus, LOW SV, thus LOW BP → syncope)

Question 5

What assessments/investigations would you do in someone with heart palpitations?

Answer 5

• Obs
• ABG
• Bloods
  
  • FBC
  • CRP
  • U&Es
  • TFTs
  • Troponin
• ECG
• CXR
• Echocardiogram

Question 6

What would you think the cause of a heart palpitation is in a young individual?

Answer 6

• Anxiety (e.g. exams)
• Diet
• Drugs & alcohol misuse
• Steroids
  
  • HIGH dose & performance enhancing → causes dilated cardiomyopathies (as steroids are TOXIC to the heart