Merry Christmas! I hope all the Elite NP readers are having an amazing holiday with friends and family!
Lets get right to it.
Have a patient complaining of hiccups? Check their pulse!
An atypical symptom of atrial fibrillation and atrial flutter can be hiccups!
I have seen this 2 times in my career. Once working in the ER and another time in an urgent care. The patients presented with unrelenting hiccups for 2-3 days. They tried everything imaginable to stop them with no relief. I checked their pulse and listened to their heart and sure enough, it was very irregular. We put them on a monitor and one patient was in a-fib and the other a-flutter. They were not complaining of any other symptoms.
So remember: if you see hiccups, check that pulse!
What else can cause hiccups that is dangerous?
Certain neurological conditions, GI conditions, pneumonia, and multiple others. The differential is large. The a-fib and a-flutter have been ones that I have personally seen.