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Heart Rhythm Disorders (cont.)

When to seek medical care if you have an arrhythmias (heart rhythm disorder)

Most people have noticed their heart racing, a fluttering in the chest, or a sensation that the heart skipped a beat. If this happens once, or very infrequently, with no other symptoms, it is usually not serious and medical care is usually not needed. However, any questions or concerns should be discussed with a health care professional. If the person is prescribed a medication, the health care professional should also be notified if a recommended treatment does not alleviate the symptoms.

More serious symptoms should be evaluated immediately at the nearest hospital emergency department. These symptoms include:

  • Any unexplained shortness of breath
  • Loss of consciousness
  • Light-headedness or feeling faint
  • Feeling that the heart is beating too slowly or too quickly
  • Chest pain with normal activity
  • Chest pain with any of the above symptoms

People experiencing these symptoms should not drive to the emergency department. They should call 9-1-1 for emergency medical transport.

How are arrhythmias (heart rhythm disorders) diagnosed?

Evaluation of rhythm disorders usually requires a detailed discussion of symptoms and a physical exam with a health care professional.

In addition, an electrocardiogram (ECG or EKG) is mandatory to establish the exact type of arrhythmia. If the rhythm disturbance is present while the ECG is being recorded, the problem may be identified immediately. Otherwise, more specialized testing may be required. A 24-hour (or longer) recording of the heartbeat is often necessary to detect any rhythm problem that occurs daily but not constantly. (For examples of EKGs of various arrhythmias, the reader is urged to see the references provided in this introductory article.)

However, if the arrhythmia is even more infrequent, an event recorder may be used. These recorders can be hand-held machines that are activated by the patient whenever he or she feels symptoms. These event recorders can be worn for variable amounts of time from days to weeks in order to detect changes in the heart's rhythm. Some recorders are placed surgically under the skin and left there for up to 1 year.

An ultrasound of the heart, called an echocardiogram, is often used for an evaluation of the structure and function of the heart that may help identify underlying causes that lead to arrhythmias.

In general, arrhythmias in children are diagnosed with most of the same tests that are used in adults.

What is the treatment for arrhythmias (heart rhythm disorders)?

Patient Comments

The treatment of arrhythmias varies depending on the presence or absence of symptoms, how frequent the arrhythmia occurs, and the seriousness of any underlying heart condition. The majority of arrhythmias are either not treated or are treated with medications taken by mouth. Some arrhythmias must be treated emergently with electrocardioversion or the patient will die. For others, the treatment may range from vagal maneuvers (for example, the Valsalva, a maneuver of breath holding and bearing down) to medication to more advanced surgical procedures, such as an internal implanted pacemaker or cardiac defibrillator (ICD). Sometimes, no treatment is necessary because the arrhythmia resolves.

Except in life-threatening emergencies, a person should have a detailed discussion of the tests and treatment options with the health care professional to be clear about the tests and potential treatment options before any tests or surgery is done. This discussion should include the risks and benefits the patient may have if they choose to have or not have specific treatments or surgical procedures done.

Medically Reviewed by a Doctor on 11/20/2017

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