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Source: Disturbances Of The Heart
This condition is generally termed by the patient a "palpitation,"
and palpitation of the heart is recognized by most physicians as
meaning a too rapidly acting heart, the term "tachycardia" being
reserved for an excessive rapidity of the heart. Many of the so-
called tachycardias are really instances of auricular fibrillation
or flutter. Some persons normally have a pulse and heart too rapid;
children more or less constantly have a heart beat of from 90 to
100. Women have more rapid heart action than men, and it becomes
more rapid with their varying functions, specifically increasing its
rapidity before, and perhaps during, menstruation. Many patients
have a rapid heart action with the slightest increase in temperature
and in any fever process. Some have a rapid heart action after the
least exertion without any cardiac lesion or assignable excuse for
such rapidity. Others have a rapid heart with mental activity and
excessive excitement. Therefore in deciding that a heart is
abnormally rapid one must individualize the patient.
During or after illness many patients are said to have palpitation
when the real cause is an unhealed myocarditis. Tuberculosis almost
invariably causes increased heart action, even when there is no
fever. All high fever increases the heart's action, but not so
markedly in typhoid fever as in other fevers; in fact, the heart in
typhoid fever, during the early stages, is apt to be slower than the
temperature would seem to call for. In anemia when the patient is
active the heart is generally rapid. The rapid heart from cardiac
disease has already been considered. For the palpitation or rapid
heart Just described there is little necessity for other treatment
than what the acute or chronic condition would call for. With proper
management the condition will improve unless the patient has an
idiosyncrasy for intermittent attacks of slightly rapid heart, as
from 100 to 120 beats per minute.
A permanently rapid heart, when the patient has no heart lesion and
is at rest, is generally due to hypersecretion of the thyroid, which
will be discussed later. Paroxysmal tachycardia is a name applied to
very rapid heart attacks in persons who are more or less subject to
their recurrence. They may occur without any tangible excuse, and
are liable to occur during serious illness, after a large meal,
after a cup of tea or coffee, or after taking alcohol. The heart may
beat as rapidly as from 150 to 200 times a minute, or even more,
with no other symptoms than a feeling of constriction or tightness
in the chest, an inability to respire properly and a feeling of "air
hunger." The patient almost invariably must sit up, or at least have
his head raised. Attacks of cardiac delirium (often auricular
fibrillation) may occur with serious lesions of the heart, as
valvular disease or sclerosis, but paroxysmal tachvcardia occurs in
certain persons without any tangible cardiac excuse. The auricles of
the heart may act more energetically than normal, and precede as
usual the ventricular contraction; or the auricles and ventricles
may contract almost together--a so-called "nodal" type of
contraction. Rarely does a patient die of paroxysmal tachycardia.
The length of time the attack may last varies from a few minutes to
an hour, or even for a day or more.
Next: Paroxysmal Tachycardia Management
Previous: Bradycardia Symptoms