Palpitation differential diagnosis: Difference between revisions

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==Differentiating [Disease name] from other Diseases==
==Differentiating [Disease name] from other Diseases==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].


OR
*Palpitation in itself is not a condition but a symptom reflective of an underlying condition.
*When coming up with a differential diagnoses, it would be useful to link positive history and physical examination findings to any of the following 5 categories ;
*# Cardiac (Arrythmia Related)
*# Cardiac (Not related to Arrythmias)
*# Systemic Causes (Non Cardiac)
*#Pharmacological Causes
*#Psychiatric Causes <ref name="pmid28613787">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=28613787 | doi= | pmc= | url= }} </ref><ref name="pmid15742913">{{cite journal| author=Abbott AV| title=Diagnostic approach to palpitations. | journal=Am Fam Physician | year= 2005 | volume= 71 | issue= 4 | pages= 743-50 | pmid=15742913 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15742913  }} </ref><ref name="pmid21697315">{{cite journal| author=Raviele A, Giada F, Bergfeldt L, Blanc JJ, Blomstrom-Lundqvist C, Mont L | display-authors=etal| title=Management of patients with palpitations: a position paper from the European Heart Rhythm Association. | journal=Europace | year= 2011 | volume= 13 | issue= 7 | pages= 920-34 | pmid=21697315 | doi=10.1093/europace/eur130 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21697315  }} </ref><ref name="pmid21766757">{{cite journal| author=Wexler RK, Pleister A, Raman S| title=Outpatient approach to palpitations. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 1 | pages= 63-9 | pmid=21766757 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21766757  }} </ref><ref name="pmid29431371">{{cite journal| author=Wexler RK, Pleister A, Raman SV| title=Palpitations: Evaluation in the Primary Care Setting. | journal=Am Fam Physician | year= 2017 | volume= 96 | issue= 12 | pages= 784-789 | pmid=29431371 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29431371  }} </ref>


[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].


OR
{| class="wikitable"
 
|+
As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
! Cardiac (Arrhythmia related) Differentials
 
! Cardiac (Not Arrhythmia related) Differentials
===Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]===
! Systemic Non Cardiac Differentials
 
! Pharmacological Differentials
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
! Psychiatric Differentials
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases
| colspan="6" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
! colspan="7" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings
| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings
|-
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
! colspan="3" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical examination
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 3
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
|  
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*Premature ventricular contractions
| style="background: #F5F5F5; padding: 5px;" |
*Premature Atrial Contractions
| style="background: #F5F5F5; padding: 5px;" |
*Ventricular tachycardia
| style="background: #F5F5F5; padding: 5px;" |
*Ventricular fibrillation
| style="background: #F5F5F5; padding: 5px;" |
*Atrial fibrillation
| style="background: #F5F5F5; padding: 5px;" |
*Atrial flutter
| style="background: #F5F5F5; padding: 5px;" |
*Postural orthostatic tachycardia syndrome
| style="background: #F5F5F5; padding: 5px;" |
*Brugada syndrome
| style="background: #F5F5F5; padding: 5px;" |
*Sinus tachycardia
| style="background: #F5F5F5; padding: 5px;" |
*Paroxysmal supraventricular tachycardia
| style="background: #F5F5F5; padding: 5px;" |
*Tachycardia with variable block,
| style="background: #F5F5F5; padding: 5px;" |
*Wolff-Parkinson-White syndrome
| style="background: #F5F5F5; padding: 5px;" |
*Long QT syndrome
| style="background: #F5F5F5; padding: 5px;" |
*Polymorphic Ventricular Tachycardia
| style="background: #F5F5F5; padding: 5px;" |
*Bradycardia caused by advanced arteriovenous block
*Bradycardia-tachycardia syndrome (sick sinus syndrome)
*Multifocal atrial tachycardia
*Pacemaker-mediated tachycardia
*Catecholamine Sensitive Arrythmia
*AV Re-entry tachycardia
*AV Nodal Re-entry Tachycardia
|
*Congenital heart disease
*Cardiomegaly
*Aortic aneurysm
*Myocardial Ischemia
*Mitral Valve Prolapse
*Hypertrophic Obstructive Cardiomyopathy
*Atrial Septal Defect
*Congestive Heart Failure
*Stenotic/ Regurgitant Valvular Heart Diseases
*Cardiomyopathy
*Pericarditis
*Ventricular Septal Defect
*Atrial Myxoma
*Anemia
*AV fistula
*Paget's disease
*Pregnancy 
|
*Thyrotoxicosis
*Mastocytosis
*Exercise
*Electrolyte imbalance
*Hypoglycemia
*Hypovolemia
*Pheochromocytoma
*Pulmonary disease
*Vasovagal syndrome
*Obstructive Sleep Apnea
*Food poisoning
|
*Caffeine
*Cocaine
*Amphetamine
*Digitalis,
*Phenothiazine
*Theophylline
*Beta agonists
*Alcohol
*Tobacco
|
*Stress
*Anxiety disorder
*Panic disorder
*Somatization Disorder
*Express Hypochondria type behavior
*Depression
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
| style="background: #F5F5F5; padding: 5px;" |
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
!Symptom 1
! colspan="1" rowspan="1" |Symptom 2
!Symptom 3
!Physical exam 1
! colspan="1" rowspan="1" |Physical exam 2
!Physical exam 3
!Lab 1
!Lab 2
!Lab 3
!Imaging 1
!Imaging 2
!Imaging 3
!Histopathology
|'''Gold standard'''
!Additional findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
| style="background: #F5F5F5; padding: 5px;" |
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6
| style="background: #F5F5F5; padding: 5px;" |
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|}
|}


==References==
==References==

Revision as of 17:57, 5 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[2]

Overview

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Differentiating [Disease name] from other Diseases

  • Palpitation in itself is not a condition but a symptom reflective of an underlying condition.
  • When coming up with a differential diagnoses, it would be useful to link positive history and physical examination findings to any of the following 5 categories ;
    1. Cardiac (Arrythmia Related)
    2. Cardiac (Not related to Arrythmias)
    3. Systemic Causes (Non Cardiac)
    4. Pharmacological Causes
    5. Psychiatric Causes [1][2][3][4][5]


Cardiac (Arrhythmia related) Differentials Cardiac (Not Arrhythmia related) Differentials Systemic Non Cardiac Differentials Pharmacological Differentials Psychiatric Differentials
  • Premature ventricular contractions
  • Premature Atrial Contractions
  • Ventricular tachycardia
  • Ventricular fibrillation
  • Atrial fibrillation
  • Atrial flutter
  • Postural orthostatic tachycardia syndrome
  • Brugada syndrome
  • Sinus tachycardia
  • Paroxysmal supraventricular tachycardia
  • Tachycardia with variable block,
  • Wolff-Parkinson-White syndrome
  • Long QT syndrome
  • Polymorphic Ventricular Tachycardia
  • Bradycardia caused by advanced arteriovenous block
  • Bradycardia-tachycardia syndrome (sick sinus syndrome)
  • Multifocal atrial tachycardia
  • Pacemaker-mediated tachycardia
  • Catecholamine Sensitive Arrythmia
  • AV Re-entry tachycardia
  • AV Nodal Re-entry Tachycardia
  • Congenital heart disease
  • Cardiomegaly
  • Aortic aneurysm
  • Myocardial Ischemia
  • Mitral Valve Prolapse
  • Hypertrophic Obstructive Cardiomyopathy
  • Atrial Septal Defect
  • Congestive Heart Failure
  • Stenotic/ Regurgitant Valvular Heart Diseases
  • Cardiomyopathy
  • Pericarditis
  • Ventricular Septal Defect
  • Atrial Myxoma
  • Anemia
  • AV fistula
  • Paget's disease
  • Pregnancy
  • Thyrotoxicosis
  • Mastocytosis
  • Exercise
  • Electrolyte imbalance
  • Hypoglycemia
  • Hypovolemia
  • Pheochromocytoma
  • Pulmonary disease
  • Vasovagal syndrome
  • Obstructive Sleep Apnea
  • Food poisoning
  • Caffeine
  • Cocaine
  • Amphetamine
  • Digitalis,
  • Phenothiazine
  • Theophylline
  • Beta agonists
  • Alcohol
  • Tobacco
  • Stress
  • Anxiety disorder
  • Panic disorder
  • Somatization Disorder
  • Express Hypochondria type behavior
  • Depression

References

  1. ↑ "StatPearls". 2020. PMID 28613787.
  2. ↑ Abbott AV (2005). "Diagnostic approach to palpitations". Am Fam Physician. 71 (4): 743–50. PMID 15742913.
  3. ↑ Raviele A, Giada F, Bergfeldt L, Blanc JJ, Blomstrom-Lundqvist C, Mont L; et al. (2011). "Management of patients with palpitations: a position paper from the European Heart Rhythm Association". Europace. 13 (7): 920–34. doi:10.1093/europace/eur130. PMID 21697315.
  4. ↑ Wexler RK, Pleister A, Raman S (2011). "Outpatient approach to palpitations". Am Fam Physician. 84 (1): 63–9. PMID 21766757.
  5. ↑ Wexler RK, Pleister A, Raman SV (2017). "Palpitations: Evaluation in the Primary Care Setting". Am Fam Physician. 96 (12): 784–789. PMID 29431371.

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