Cardiac disorders are a common cause of palpitations, and this possibility generates the most concern among clinicians. Cardiac causes of palpitations include:
Cardiac arrhythmias, including the development of a new arrhythmia or a significant change in the rate of a previously stable arrhythmia (such as atrial fibrillation). Cardiac arrhythmias may develop due to underlying structural heart disease (eg, cardiomyopathy, previous myocardial infarction) or identifiable conduction system abnormality (eg, long QT syndrome, Wolf-Parkinson-White syndrome, complete heart block), or they may be idiopathic. Arrhythmias causing palpitations include tachyarrhythmias, bradyarrhythmias, and ectopic beats. Other less common cardiac causes include valvular heart disease (eg, mitral valve prolapse), pacemaker syndrome (ie, atrioventricular dyssynchrony due to single chamber [ventricular] pacing), atrial myxoma, and high-output cardiac states. (paragraph) A 12-lead electrocardiogram must be performed on every patient complaining of palpitations. The presence of a short PR interval and a delta wave (Wolff-Parkinson-White syndrome) is an indication of the existence of ventricular pre-excitation. Significant left ventricular hypertrophy with deep septal Q waves in I, L, and V4 through V6 may indicate hypertrophic obstructive cardiomyopathy. The presence of Q waves may indicate a prior myocardial infarction as the etiology of the palpitations, and a prolonged QT interval may indicate the presence of the long QT syndrome.
| Codes | Code Description |
|---|---|
| I49.1 | Atrial premature depolarization |
| I49.5 | Sick sinus syndrome |
| I49.9 | Cardiac arrhythmia, unspecified |
| I49.02 | Ventricular flutter |
| I49.2 | Junctional premature depolarization |
| I49.3 | Ventricular premature depolarization |
| I49.40 | Unspecified premature depolarization |
| I49.49 | Other premature depolarization |
| I49.8 | Other specified cardiac arrhythmias |
| R00.0 | Tachycardia, unspecified |
| R00.1 | Bradycardia, unspecified |
| R00.2 | Palpitations |
| R00.8 | Other abnormalities of heart beat |
| R00.9 | Unspecified abnormalities of heart beat |
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