Tag Archives: palpitations

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Introduction Palpitations present frequently in primary care, and are the second most common reason for a general practitioner (GP) to refer a patient to a cardiologist.1 Levels of distress and health concern are high in this patient group, even though most of these patients do not have demonstrable heart arrhythmias.2 Moreover, it is within this group with unexplained palpitations that psychiatric and psychological morbidity is highest.3,4 Given this background, we wondered how a patient with palpitations experienced the cardiology appointment, what effect it had on the perception of their cardiac symptoms, and whether this varied according

Physical examination, electrocardiography, chest x-ray and a Bruce exercise stress test were unremarkable. A 24-hour tape revealed intermittent ventricular ectopics that coincided with his symptoms of palpitations. On non-standard views, echocardiography showed a large echolucent mass that was compressing the right ventricle (figure 1A). Left ventricular ejection fraction was preserved. Computed tomography (CT) of chest and abdomen demonstrated a massive lobulated cyst in the anterior mediastinum, arising from the pericardium, measuring 15.3 cm x 8.2 cm (figure 1B). CT-guided aspiration (figure 1C) obtained 600 ml of straw-coloured fluid (tra

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