A 52-year-old male presents to urgent care complaining of palpitations. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 96-Year-Old Male with Palpitations and a History of CAD
The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …
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A 73-Year-Old Man with a 2-Week History of Palpitations
Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …
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A 62-Year-Old Woman with Dizziness and Palpitations
Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
Read MoreClinical Challenge: September, 2013
The patient, a 76-year-old male, presented with a complaint of palpitations. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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September 2012
Management of Palpitations in Urgent Care
Urgent message: Patients with palpitations often present to urgent care clinics. Making the correct diagnosis requires knowledge of underlying pathophysiology and thorough differential diagnosis. EBRAHIM BARKOUDAH, MD, and JEFFREY P. COLLINS, MD Case Record A 75-year-old woman with no prior history of cardiac disease complained of “palpitations” but neither lightheadedness nor syncope. She denied excess caffeine intake or use of illicit drugs and had no other significant past medical history on triage. The patient’s initial …
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