What is the role of heart rate in the evaluation of symptoms of myocardial infarction (MI, heart attack)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

The patient's heart rate is often increased (tachycardia secondary to sympathoadrenal discharge). The pulse may be irregular because of ventricular ectopy, an accelerated idioventricular rhythm, ventricular tachycardia, atrial fibrillation or flutter, or other supraventricular arrhythmias.

Depressed heart rate may also be present in some cases. Bradyarrhythmias may be attributable to impaired function of the sinus node. An atrioventricular (AV) nodal block or infranodal block may also be present.

Unequal palpable pulses can be suggestive of the presence of aortic dissection, which commonly presents with chest pain radiating to the back, accompanied by a blood pressure difference of 15 mm Hg or greater between both arms and an aortic regurgitation murmur.


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