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The clinical course of palpitations in medical outpatients.

Publication ,  Journal Article
Barsky, AJ; Cleary, PD; Coeytaux, RR; Ruskin, JN
Published in: Arch Intern Med
September 11, 1995

OBJECTIVE: The aim of this study was to describe the longitudinal course of patients who were referred for ambulatory electrocardiographic monitoring because of palpitations. METHODS: A prospective, follow-up examination was conducted of patients who had been studied 6 months previously when referred for monitoring. The inception cohort consisted of 145 consecutive patients with palpitations and 70 asymptomatic, nonpatient volunteers. At follow-up, the patients completed the same research battery as at inception, consisting of structured interviews and self-report questionnaires. These assessed cardiac symptoms, medical care use, role impairment, somatization, hypochondriacal fears and beliefs, and psychiatric disorder. RESULTS: At 6 months' follow-up, 130 patients with palpitations (89.7% of the original cohort) and 69 nonpatients (98.6%) were reinterviewed. Eighty-four percent of the patients had recurrent palpitations during the 6-month follow-up period. At follow-up, patients with palpitations scored significantly higher than the comparison group on measures of cardiac symptoms and role impairment, and had made more physician visits in the preceding 6 months. They had a higher prevalence of panic disorder and more psychopathologic symptoms, somatized more, and were more hypochondriacal. Psychiatric symptoms and the tendency to amplify bodily sensation, measured at inception, were significant but modest predictors of subsequent palpitations. There was considerable confusion and misunderstanding among patients as to the findings of their ambulatory electrocardiogram and the presence or absence of panic disorder. CONCLUSIONS: Patients with palpitations remain symptomatic and functionally impaired and have increased rates of physician visits in the 6 months following Holter monitoring. They also continue to have elevated rates of panic disorder and to evidence some confusion about the cause of their symptoms.

Duke Scholars

Published In

Arch Intern Med

ISSN

0003-9926

Publication Date

September 11, 1995

Volume

155

Issue

16

Start / End Page

1782 / 1788

Location

United States

Related Subject Headings

  • Tachycardia
  • Surveys and Questionnaires
  • Role
  • Prospective Studies
  • Panic Disorder
  • Outpatients
  • Humans
  • Health Services
  • General & Internal Medicine
  • Electrocardiography, Ambulatory
 

Citation

APA
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ICMJE
MLA
NLM
Barsky, A. J., Cleary, P. D., Coeytaux, R. R., & Ruskin, J. N. (1995). The clinical course of palpitations in medical outpatients. Arch Intern Med, 155(16), 1782–1788.
Barsky, A. J., P. D. Cleary, R. R. Coeytaux, and J. N. Ruskin. “The clinical course of palpitations in medical outpatients.Arch Intern Med 155, no. 16 (September 11, 1995): 1782–88.
Barsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. The clinical course of palpitations in medical outpatients. Arch Intern Med. 1995 Sep 11;155(16):1782–8.
Barsky, A. J., et al. “The clinical course of palpitations in medical outpatients.Arch Intern Med, vol. 155, no. 16, Sept. 1995, pp. 1782–88.
Barsky AJ, Cleary PD, Coeytaux RR, Ruskin JN. The clinical course of palpitations in medical outpatients. Arch Intern Med. 1995 Sep 11;155(16):1782–1788.

Published In

Arch Intern Med

ISSN

0003-9926

Publication Date

September 11, 1995

Volume

155

Issue

16

Start / End Page

1782 / 1788

Location

United States

Related Subject Headings

  • Tachycardia
  • Surveys and Questionnaires
  • Role
  • Prospective Studies
  • Panic Disorder
  • Outpatients
  • Humans
  • Health Services
  • General & Internal Medicine
  • Electrocardiography, Ambulatory