How to Stop Heart Palpitations
Clinical characteristics of this syndrome include a decreased marrow cellularity, pancytopenia, and reticu-locytopenia. Aplastic anemia is an insidious process, and the syndrome progresses in a slow but orderly fashion with symptoms reflective of the depressed cellular elements. When red cells significantly deplete, patients will show fatigue, heart palpitations, and dyspnea. As platelets deplete, ecchymosis and mucosal bleeds develop and white count depletion leads to infections. In many cases, the peripheral smear shows lymphocy-tosis. Treatment for this normochromic normocytic anemia includes transfusion support and steroids, with a few patients recovering spontaneously.
Common symptoms seen in patients with tachyarrhythmias may include syncopal episodes, palpitations, fatigue, or dyspnea. Both invasive and noninvasive diagnostic tools are available for diagnosing tachyarrhythmias. The common noninvasive procedures include (1) a thorough patient interview (2) blood work (3) a 12-lead electrocardiogram (ECG) (4) tilt table testing (5) Holter monitoring (6) exercise stress test (7) echocardiography (8) signal average ECG and or (9) single-photon emission computed tomography multiple gated acquisition (SPECT MuGA). An electrophysiological study using cardiac catheterization and insertable loop recorders is the most commonly used invasive diagnostic procedure.
In addition to their anticholinergic side-effects (similar to those described above for the tricyclics), MAOIs may cause potentially dangerous interactions with sympathomimetic drugs (including common-cold remedies) and tyramine-containing foods (Box 23.5), which must therefore be avoided. Such interactions produce headache and palpitations rarely, they can produce a hypertensive crisis that may lead to stroke or sudden death. In order to do so, however, the
Symptoms resembling panic attacks are common in cultures where members have strong beliefs in witchcraft or evil spirit attacks (Castillo, 1997 Kirmayer, Young, & Hayton, 1995). For example, trembling or shaking, chest pain, fear of dying, palpitations, and other symptoms for Panic Disorder are generally reported by Hispanics with intensive fears of malign magic, malevolent attacks by witchcraft, or evil spirit attacks. These symptoms resemble the culture-bound syndrome named ataques de nervios among Hispanics (DSM-IV, 1994 Kirmayer et al., 1995 see Table I). The DSM-IV (1994), however, pointed out that the association of most ataques with a precipitating event and the frequent absence of the hallmark symptoms of acute fear or apprehensions distinguish these ataques from Panic Disorder (p. 845). Another culture-bound syndrome resembling Panic Disorder is Ode-ori (Table I), which is often reported among the Nigerian culture and is characterized by sensations of parasites crawling in...
Stimulation-related adverse effects depend on the exact location of the lead and the intensity of stimulation. The majority of these adverse effects can be reduced by changing the active electrode contact or by reducing the stimulation intensity. These adverse effects include eyelid apraxia, double vision, dystonic posturing, dysarthria, dyskinesia, paresthesia, limb and facial muscle spasms, depression, mood changes, paresthesias, visual disturbances, and pain. Occasionally, nonspecific sensations like anxiety, panic, palpitations, and nausea can also occur. If these adverse effects persist, this usually indicates that the electrode is not in the ideal position.
Guarnaccia, 1989 Kleinman et al., 1986 Krause & Carr 1978). Symptoms of nervios include, headaches, trembling, heart palpitations, stomach and appetite disturbances, trouble with concentration, sleep problems, and worrying (Guarnaccia & Farias, 1988). Sufferers are more frequently women than men, and they are disportionately from rural and lower class backgrounds.
Objective signs of autonomic arousal, such as palpitations, sweating, flushing, tremor, and expression of fear and distress about the possibility of a physical disorder. Second, there are subjective complaints of a nonspecific or changing nature such as fleeting aches and pains, sensations of burning, heaviness, tightness, and feelings of being bloated or distended, which are referred by the patient to a specific organ or system.
Movements such as kicking, fighting, or jumping. Night terrors and confusional episodes occur early in sleep unlike RBD and may involve screaming or incoherent speech but there is no recall of the dream. Nocturnal panic attacks in PD may complicate nocturnal akinesia with dysautonomia such as palpitations, hyperhydrosis, and immediate full awareness without dream enactment, whereas seizures may be associated with tonic-clonic posturing, tongue biting, incontinence, and postictal confusion.
This is the case of a 30 year old woman who was 7 months postpartum with no significant past medical history. The present illness began 6 weeks after delivery, when tachycardia, palpitations and exophtalmos led to the diagnosis of Grave's disease. Treatment with propylthiouracil (PTU) and propranolol was prescribed. Her palpitations decreased initially, but after a few months her symptoms worsened. She suffered 3 syncopal episodes within the 3 months prior to admission, each lasting a few seconds. Her liver enzymes increased mildly, and the PTU was discontinued. She developed orthopnea, fever of 39 C, weight loss, diarrhea and decreased urine output.
In a review by Smith (17), the safety and tolerability of rHuIL-11 administered sc at the recommended dose of 50 g kg d was compared with placebo in two phase 2 studies. The dataset included 308 patients, ranging from 8 mo to 75 yr of age, who received up to eight sequential 1-28-d courses of oprelvekin. In this group, aside from complications associated with underlying malignancy or cytotoxic chemotherapy, most adverse events were of mild or moderate severity and were reversible after cessation of the growth factor. The incidence and type of adverse events were similar between patients who received oprelvekin and those who received placebo. Edema, dyspnea, tachycardia, conjunctival injection, palpitations, and pleural effusion occurred more frequently in the oprelvekin-treated patients. Adverse events that occurred in 10 of patients and were observed in equal or greater frequency among patients receiving placebo included asthenia, pain, chills, abdominal pain, infection, anorexia,...
The most frequent reason for presentation to a general practitioner of the bulimic patient was to request a weight loss diet (82). Other common presenting complaints include gastrointestinal symptoms, such as bloating or constipation, and amenorrhea or irregular cycles (83). Rarely, patients may present with palpitations or cardiac arrhythmias secondary to electrolyte imbalance. Pathognomonic signs in bulimia nervosa include a ''chipmunk'' cheek appearance, due to noninflammatory stimulation of the salivary glands, particularly the parotids (84) (Fig. 1). Erosions of the lingual surface of the teeth and multiple dental caries are seen, due to the exposure to acid from repeated vomiting (85). Russell's sign (86) (scarring and abrasions on the dorsum of the hands during self-induced vomiting) can also be seen (Fig. 2). Laboratory abnormalities, which may be frequent in purging patients, include metabolic alka-losis and hypokalemia (87).
History of the Present Illness Rate of onset of shortness of breath (gradual, sudden), orthopnea (dyspnea when supine), paroxysmal nocturnal dyspnea (PND), chest pain, palpitations. Dyspnea with physical exertion history of myocardial infarction, syncope. Past episodes aggravating or relieving factors (noncompliance with medications, salt overindulgence). Edema, weight gain, cough, sputum, fever, anxiety hemoptysis, leg pain (DVT).