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Physical examination

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

During an episode of palpitations observe the following:

  • heart rate
  • co-ordination of atrial and ventricular contraction
  • blood pressure
  • heart sounds
  • arterial pulsations
  • jugular pulsations

The following is a summary of the physical findings for the major arrhythmias:

  • AF - bp variable, heart sounds variable, arterial pulse - irregular, jugular pulsation - absent
  • AVNT - bp - fixed, heart sounds - fixed, arterial pulse - regular, jugular pulsation - neck+
  • CMT/AT - bp - fixed, heart sounds - fixed, arterial pulse - regular, jugular pulsation - neck-
  • VT - bp - variable, heart sounds - variable, arterial pulse - regular, jugular pulsation - canon waves

(AF = atrial fibrillation, AVNT = atrioventricular nodal tachycardia, CMT = circus movement tachycardia, AT = atrial tachycardia, VT = ventricular tachycardia, neck+ = palp- itation felt in neck as well as chest, neck- = palpitation felt only in chest).

Patients examined when the palpitations have subsided are invariably normal (except for the signs of any underlying heart disease).

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