Symptoms Of Fatigue And Dyspnea On Exertion

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1. Fatigue and dyspnea on exertion are two common symptoms associated with mitral valve dysfunction. Many patients may not even show any signs and symptoms in the initial years except tiredness and fatigue. According to Shipton & Wahba, signs and symptoms of mitral dysfunctions include dyspnea on exertion, palpitations, orthopnea, chest discomfort, paroxysmal nocturnal dyspnea, and eventually leading to signs of right-sided heart failure.
Although, mitral dysfunctional may be asymptomatic to begin with, exercises can trigger fatigue, dyspnea and palpitations in the early years.
2. Palpitation is often described by patient as an increased self-awareness of heartbeats – feeling of heart beating faster, harder or skipping a beat.
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For example, Yalamanchili, Khurana & Smaha,2003a, pointed out that a feeling of palpitations in flip-flops can occur secondary to premature atrial or ventricular contraction and feeling of rapid fluttering or palpitations that start and stop abruptly can be a sign of supra ventricular tachyarrhythmias. 3. Even though, palpitations can occur due to cardiac or non-cardiac reasons, detailed evaluation will help physical therapist to know if palpitations are related to underlying cardiac conditions. The main symptoms that may be seen associated with palpitations are chest pain or discomfort, syncope, anxiety, fatigue, light headedness, and dizziness, as suggested by
Yalamanchili, Khurana & Smaha, 2003b.
4. Palpitation can also occur due to non-cardiac reasons. Barsky, Cleary, Sarnie & Ruskin,
1994, outlined other major reasons for palpitations and they are metabolic causes, medicine induced palpitations, and psychiatric causes. Major metabolic causes include hyperthyroidism, hypoglycemia, hypo/hyperkalemia, and hypo/hypercalcemia. Drugs such as beta blockers,
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PT 819 ASSESSSMENT 3 3 psychiatric disorders like panic disorders, depression, hypochondriasis, and general anxiety can also induce palpitations.
5. Syncope that occurs without any warning period of lightheadedness, dizziness, or nausea may be a sign of heart valve or arrhythmia problems .
6. Cardiovascular causes for syncope are generally either electrical in the form of cardiac arrhythmias or mechanical in the form of obstruction of central circulation occur at valves or blood vessels as suggested by Farrehi, Santinga & Eagle, 1995. Among non cardiovascular causes, vasomotor syncope is the most common cause of syncope. They include orthostatic hypotension and vasovagal reasons. Other causes include carotid sinus hypersensitivity, metabolic causes like hypoxia, hypoglycemia, and altered hormonal levels, neurological

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