Differential Diagnosis for Reported Uneven Pulse
Single Most Likely Diagnosis
- Atrial Fibrillation: This is the most common cardiac arrhythmia, characterized by an irregular and often rapid heart rate. It is a common cause of uneven pulse and can be confirmed with an electrocardiogram (ECG).
Other Likely Diagnoses
- Premature Atrial Contractions (PACs): These are early electrical impulses originating in the atria that can cause an uneven pulse. They are often benign but can be a source of concern for patients.
- Premature Ventricular Contractions (PVCs): Similar to PACs, PVCs are early electrical impulses originating in the ventricles, leading to an uneven pulse. They can be associated with various conditions, including anxiety, caffeine intake, and underlying heart disease.
- Sinus Arrhythmia: This is a normal variation in heart rate that can cause an uneven pulse, often associated with respiration. It is more common in younger individuals and athletes.
Do Not Miss Diagnoses
- Ventricular Tachycardia: Although less common, this is a potentially life-threatening arrhythmia that requires immediate medical attention. It is characterized by a rapid, regular heartbeat originating from the ventricles.
- Cardiac Block (Second or Third Degree): These conditions involve a disruption in the electrical conduction system of the heart, leading to an uneven pulse. They can be asymptomatic or present with severe symptoms, including syncope and heart failure.
- Wolff-Parkinson-White Syndrome: A rare condition involving an accessory electrical pathway in the heart, which can cause an uneven pulse and increase the risk of arrhythmias.
Rare Diagnoses
- Paroxysmal Supraventricular Tachycardia (PSVT): A condition characterized by episodes of rapid heart rate that start in the upper chambers of the heart. It can cause an uneven pulse during episodes.
- Sick Sinus Syndrome: A condition where the sinoatrial node does not function properly, leading to various arrhythmias, including those causing an uneven pulse.
- Cardiac Sarcoidosis: A rare condition where granulomas form in the heart, potentially disrupting its electrical system and leading to arrhythmias, including those causing an uneven pulse.