Atrial Flutter (cont.)
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Exams and Tests
Upon hearing about the symptoms, the health care provider (whether a primary care provider or a provider in the emergency department) may suspect an arrhythmia. Because many different arrhythmias can cause similar symptoms, the evaluation at first focuses on ruling out the most dangerous ones. One simple test, the electrocardiogram (ECG), can help tell a lot about what is happening with the heart.
The ECG measures and records the electrical impulses that control the beating of the heart.
People sometimes have symptoms suggesting arrhythmias, but when the ECG is recorded, the result is normal. This may mean that the arrhythmia comes and goes (paroxysmal atrial flutter), a common condition, or it may mean an arrhythmia does not exist, and the heart feels odd or jumpy because of other factors, such as anxiety. If the ECG result is normal, an ambulatory ECG may be performed for 24 hours using a Holter monitor or for a longer period using an event monitor.
An ambulatory ECG involves a person wearing a monitoring device for a few days while going about normal activities. The purpose of an ambulatory ECG is to obtain documented proof of the arrhythmia. Proof is important because treatment depends upon identification of the arrhythmia.
An echocardiogram is an ultrasound test that uses sound waves to make a picture of the inside of the heart while it is beating. In this test, an ultrasound probe is positioned on the outer chest wall, and the images obtained are viewed on a monitor.
Occasionally, atrial flutter is detected in people with no symptoms when they see their health care provider for another reason. The health care provider may notice unusual heart sounds or an unusual pulse on physical exam, and he or she may order an ECG.
Noel G Boyle, MB, BCh, MD, PhD
Theodore A Spevack, DO
Kathryn L Hale, MS, PA-C
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