心悸palpitation概要.ppt

Palpitation 心悸 Definition Palpitation may be defined as an awareness of the beating of the heart.心悸是病人自觉心脏跳动的不适感 an awareness commonly brought about by a change in the heart’s rhythm (节律) or rate (频率) or by an augmentation of its contractility (收缩力增强). Definition Palpitation does not means heart disease. The degree of palpitation is not equal to the severity of heart disease. Patients with anxiety states often exhibit a lowered threshold 阈点 at which disorders of rate and rhythm result in palpitation. Definition Persistent tachycardia (持续心动过速) or atrial fibrillation(心房颤动) may not be accompanied by continual palpitation. A sudden, brief alteration (改变) in cardiac rate or rhythm which often causes considerable subjective discomfort. Etiology Augmentation of heart contractility (心脏搏动增强) Arrhythmia(心律失常) Cardiac neurosis(心脏神经官能症) Augmentation of heart contractility Physiological augmentation 生理性 Pathological augmentation 病理性 Physiological augmentation Exercising strongly and overnervous After drinking coffee, tea, alcohol Taking medicine such as ephedrine(麻黄素), aminophylline(氨茶碱), atropin (阿托品) etc. Physiological augmentation Character Short duration 持续时间短 Accompanied by chest tightness 可伴有胸闷 Don’t affect the normal activities 不影响正常活动 Pathological augmentation Ventricular hypertrophy (enlargement) 心室肥厚（心室扩大） hypertensive heart disease 高血压性心脏病 valvular insufficiency 瓣膜关闭不全 Congenital heart disease 先天性心脏病 Heart pre-load（前负荷）or afterload（后负荷）increase → hypertrophy心肌肥厚 → augmentation of contractility 心肌收缩力增强→ palpitation Pathological augmentation Other diseases which increase cardiac output Thyrotoxicosis(甲亢): basic metabolism amplify基础代谢率增加 and sympathetic nerve excite交感神经兴奋→heart rates↑ Anemia(贫血): hypoxaemia低氧血症 → heart rates↑ Fever: basic metabolism amplify Hypoglycemia(低血糖) Pathological augmentation Character Long duration repeated attack 持续时间长，反复发作 Accompanied by chest tightness, Shortness of breath气急, Precordial pain心前区疼痛, Syncope晕厥 aff