Mostly cardiac arrhythmias. The heart usually beats very regularly. When the heart beats too fast, too slow, or with intermittent disturbances, it is called an arrhythmia. Arrhythmias can be detected by touching the pulsations of the radial artery with the hand, but a detailed examination must be done with an electrocardiogram. In daily life, the heart rate of a normal person is approximately 50-100 beats per minute on average. When the heart beats more than 100 times per minute, it is called tachycardia. When the heart beats less than 60 times per minute, it is called bradycardia. How to check the number of pulse beats per minute that cannot be counted? I. Questioning In addition to understanding the general medical history, the focus should be on asking the following two aspects. 1, the arrhythmia attack for most patients, the arrhythmia attack often can not be seen by the doctor, especially when the arrhythmia is intermittent occurrence, therefore, to the patient or informed people (including witnesses) detailed questioning is very necessary. It is important to understand not only the cause, number, frequency, and duration of the attack. In addition to the mode or process of remission, it is more important to ask the patient about the sensation, blood pressure, heart rhythm (rate) and the presence of palpitations, dizziness J black, syncope, convulsions, shortness of breath and dyspnea when the arrhythmia occurs. Although most arrhythmias are seen in patients with organic heart disease, there are also many cases that occur in other system diseases or even in “healthy” people, therefore, in addition to asking about the symptoms of the cardiovascular system, attention should be paid to understanding the symptoms outside the cardiovascular system, especially the endocrine system, respiratory system, hematological system, infections, and other diseases, Therefore, in addition to the symptoms of the cardiovascular system, we should also pay attention to the symptoms outside the cardiovascular system, especially the endocrine system, respiratory system, blood system, infection, water-electrolyte balance and medication. Physical examination of patients with arrhythmias should pay attention to three points: 1. The frequency and characteristics of arrhythmias are mainly done through cardiac auscultation. Although most arrhythmias have to be determined by electrocardiography, some simple arrhythmias such as premature beats and atrial fibrillation can basically be diagnosed by auscultation. 2.Evidence of organic heart disease such as enlarged heart, organic heart murmur, cardiac insufficiency, etc. 3. Other system abnormalities such as goiter, pulmonary hypertension, anemia, infection and other signs are noted. For the qualitative diagnosis of arrhythmia, electrocardiogram is undoubtedly the simplest and most reliable method, but it can only record the heart rhythm (rate) for a short period of time, which makes the diagnosis of intermittent arrhythmia difficult. It can continuously record the rhythm (rate) changes of patients within 24-48h, which is important for the qualitative and quantitative diagnosis of arrhythmias, but there are certain disadvantages of dynamic ECG, such as more expensive, not real-time display, and less accurate positioning than conventional ECG due to the small number of leads. ECG monitoring, on the other hand, combines the advantages of ECG and ECG, which can be observed dynamically and displayed in real time, especially with the functions of alarm and automatic recording, bringing great convenience to clinical diagnosis. In recent years, the clinical application of ventricular membrane potential, heart rate variability analysis, esophageal or intracardiac electrophysiological examination and other methods are mainly helpful in determining the prognosis of patients or the risk of arrhythmia, as well as the discussion of the mechanism of arrhythmia occurrence. Once diagnosed, patients are often highly stressed, anxious, depressed, seriously concerned, and frequently seek medical attention, urging for medication to control arrhythmias. But completely ignore the causes and triggers of the prevention and treatment, often resulting in the clamor for the main, the cart before the horse. Common causative factors: smoking, alcoholism, overwork, stress, excitement, overeating, indigestion, fever, excessive salt intake, low blood potassium, blood magnesium, etc. Patients can combine the actual situation of previous attacks, summarize the experience and avoid possible triggers, which is easier, safer and more effective than just using drugs.