Palpitation Au Niveau Du Cou
Darleen Lamphere
If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.
Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 10.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium. From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body.
Two distinguishable sounds can be heard during the cycle of the beating heart when listened to with a stethoscope. The heart sounds are usually described as a lup-dup sound. These sounds are due to the closing of the valves of the heart. Unusual heart sounds are called murmurs.
The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers. The SA node (anatomical pacemaker) starts the sequence by causing the atrial muscles to contract. From there, the signal travels to the AV node, through the bundle of His, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an electrocardiogram (EKG or ECG). Doctors use an EKG to monitor the cardiac conduction system's electrical activity in the heart.
Once a serious cause has been ruled out by your health care provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
Reviewed by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Les palpitations cardiaques correspondent une perception anormale des battements du cœur. Ceux-ci paraissent trop forts ou trop rapides et peuvent tre perus comme tant rguliers ou anormalement dsordonns.
Mais, lorsqu'elles sont accompagnes de douleurs thoraciques, d'essoufflement, de malaises, de sueurs ou d'angoisse, elles peuvent traduire l'existence d'un trouble du rythme cardiaque et d'une maladie cardiovasculaire.
Le systme nerveux externe au cœur ajuste la frquence et la force de contraction du cœur pour rpondre aux besoins de l'organisme. Son action est ralise, par exemple, selon les efforts physiques fournis par l'individu.
Le systme nerveux interne au cœur permet de coordonner les battements des oreillettes et des ventricules. Le battement des oreillettes dclenche normalement celui des ventricules un rythme synchronis.
De multiples facteurs peuvent tre l'origine de palpitations cardiaques. Certains sont lis aux habitudes de consommation de certains produits, une circonstance de vie, des troubles motionnels ou encore la prise de certains mdicaments. D'autres sont en lien avec un problmes cardiaques ou certaines maladies ou symptmes.
Pendant la grossesse, le rythme cardiaque de la femme enceinte augmente et des palpitations sont parfois ressenties. Celles-ci sont lies des modifications hormonales mais aussi au volume de sang qui augmente chez la femme pendant toute la priode de gestation. Son cœur est alors plus sollicit.
Des palpitations peuvent tre prsentes en cas de maladie du cœur et rvler un trouble du rythme et de la conduction cardiaque (fibrillation auriculaire, flutter, tachycardie, etc.) C'est le cas notamment lors :
Palpitations are defined as rapid pulsations or abnormally rapid or irregular beating of the heart. They are often described as the perception of a skipped beat, rapid fluttering in the chest, pounding sensation in the chest or neck, or a flip-flopping in the chest. Palpitations are common, nonspecific and can be a symptom or a diagnosis. While the cause of palpitations is usually benign, there are underlying life-threatening conditions that may present with palpitations. This activity illustrates the evaluation and treatment of palpitations and reviews the role of the interprofessional team in managing those with this condition.
Objectives:
- Define palpitations.Explain how patients might describe palpitations.Review the evaluation of palpitations.Examine the role of interprofessional team members in optimizing collaboration and communication to ensure patients with palpitations receive high-quality care, which will lead to enhanced outcomes.
Palpitations are one of the more common complaints of patients who presented to emergency departments, primary care providers, or cardiologists. In one study, it was estimated that 16% of patients presenting to their primary care provider reported palpitations. The word palpitation is defined as a rapid pulsation, an abnormally rapid or irregular beating of the heart. Palpitations are a sensory symptom and are often described as a skipped beat, rapid fluttering in the chest, pounding sensation in the chest or neck, or a flip-flopping in the chest. Palpitations are nonspecific and can be a symptom or a diagnosis. While the cause of palpitations is most commonly benign, they may be a sign of a life-threatening condition.[1]
The current knowledge of the neural pathways responsible for the perception of the heartbeat not clearly elucidated. It has been hypothesized that these pathways include different structures located both at the intracardiac and extracardiac level. Palpitations are a widely diffused complaint and particularly in subjects affected by structural heart disease. The list of etiologies of palpitations is long, and in some cases, the etiology is unable to be determined. In one study reporting the etiology of palpitations, 43% were found to be of cardiac etiology, 31% of psychiatric etiology and approximately 10% were classified as miscellaneous (medication induced, thyrotoxicosis, caffeine, cocaine, anemia, amphetamine, mastocytosis).[1]
The cardiac etiologies of palpitations are the most life-threatening and include ventricular sources (premature ventricular contractions, ventricular tachycardia and ventricular fibrillation), atrial sources (atrial fibrillation, atrial flutter) high output states (anemia, AV fistula, Paget's disease or pregnancy), structural abnormalities (congenital heart disease cardiomegaly, aortic aneurysm, or acute left ventricular failure), and miscellaneous sources (postural orthostatic tachycardia syndrome POTS, Brugada syndrome, and sinus tachycardia).[1][2]
Palpitations can occur during times of catecholamine excess, such as during exercise or at times of stress. The cause of the palpitations during these conditions is often a sustained supraventricular tachycardia or ventricular tachyarrhythmia. Supraventricular tachycardias can also be induced at the termination of exercise when the withdrawal of catecholamines is coupled with a surge in the vagal tone. Palpitations secondary to catecholamine excess may also occur during emotionally startling experiences, especially in patients with a long QT syndrome.[1][2]
Many psychiatric conditions can result in palpitations including depression, generalized anxiety disorder, panic attacks, and somatization. However one study noted that up to 67% of patients diagnosed with a mental health condition had an underlying arrythmia. [1][2][3]
There are many metabolic conditions that can result in palpitations including, hyperthyroidism, hypoglycemia, hypocalcemia, hyperkalemia, hypokalemia, hypermagnesemia, hypomagnesemia, and pheochromocytoma.[1][2]
The medications most likely to result in palpitations include; sympathomimetic agents, anticholinergic drugs, vasodilators and withdrawal from beta blockers. Common etiologies also include excess caffeine, or marijuana. Illicit drug use such as cocaine, amphetamines, 3-4 methylenedioxmethamphetamine (Ectasy or MDMA) and can also cause palpitations.[1][2][4]
Palpitations are a very common complaint in the general population, and particularly in those affected by structural heart disease. Clinical presentation is divided into four groups: extrasystolic, tachycardic, anxiety-related, and intense. Anxiety-related is the most common. [5]
The sensation of palpitations can arise from extrasystoles or tachy-arrythmias. It is very rarely noted due to bradycardia. Palpitations can be described in many ways. The most common descriptions include a flip-flopping in the chest, a rapid fluttering in the chest, or pounding in the neck. The description of the symptoms may provide a clue regarding the etiology of the palpitations, and the pathophysiology of each of these descriptions is thought to be different. In patients who describe the palpitations as a brief flip-flopping in the chest, the palpitations are thought to be caused by extra systoles such as supraventricular or ventricular premature contractions. The flip-flop sensation is thought to result from the forceful contraction following the pause and the sensation that the heart is stopped results from the pause. The sensation of rapid fluttering in the chest is thought to result from a sustained ventricular or supraventricular arrhythmia. Furthermore, the sudden cessation of this arrythmia can suggest paroxysmal supraventricular tachycardia. This is further supported if the patient can stop the palpitations by using Valsalva maneuvers. The rhythm of the palpitations may indicate the etiology of the palpitations (irregularly irregular palpitations indicate atrial fibrillation as a source of the palpitations). An irregular pounding sensation in the neck can be caused by atrioventricular dissociation, and the subsequent atria are contracting against a closed tricuspid and mitral valves, thereby producing cannon A waves. Palpitations induced by exercise could be suggestive of cardiomyopathy, ischemia or channelopathies.[2][6]
d3342ee215