ARRHYTHMIAS IN GENERAL-PRACTICE - DIAGNOSTIC-VALUE OF PATIENT CHARACTERISTICS, MEDICAL HISTORY AND SYMPTOMS

Background. Complaints possibly caused by arrhythmias are frequently s een in general practice. It is unclear to what extent such complaints can differentiate between arrhythmias and other pathology in general p ractice. Objectives. We aimed to assess the value of symptoms (a) in d iagnosing arrhythmias in general practice and (b) in identifying patie nts with clinically relevant arrhythmias. Method. During a 2-year peri od, a structured history from 762 patients with new complaints possibl y related to an arrhythmia was taken by the GP, and a transtelephonic electrocardiogram (ECG) was made. Results. In 28.3% of the patients, a rrhythmias were detected and 8.8% were clinically relevant. Several pa tient characteristics, symptoms and medical history findings have high predictive values in diagnosing arrhythmias. In the logistic regressi on analysis, age and, to a lesser extent, male gender, palpitations an d dyspnoea during consultation and the use of cardiovascular drugs are associated with the presence of arrhythmias. In detecting clinically relevant arrhythmias the same parameters apart from gender are importa nt, as well as a history of arrhythmias. The use of central nervous sy stem medication and frequent psychosomatic complaints are negatively a ssociated with the presence of clinically relevant arrhythmias. Conclu sions. In general practice, patient characteristics, symptoms and medi cal history findings can be used in the detection of arrhythmias and t he assessment of their severity. They can help in the decision of whet her to make an ECG recording.