Case A 44-year-old man presents to your urgent care center complaining of intermittent dizziness. He denies shortness of breath, fever, chest pain, and syncope. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreAn 82-Year-Old Man with Palpitations
An 82-year-old man presents with complaints of palpitations. He denies chest pain, shortness of breath, dizziness, fever, vomiting, or confusion. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 26-Year-Old Man with Palpitations
The patient is a 26-year-old man who presents after 3 days of palpitations. He denies any chest pain, shortness of breath, diaphoresis, fever, or dizziness. He does use home oxygen (2 L/min), but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented X 3 Lungs: Clear to auscultation bilaterally Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding Extremities: No pain …
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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 MoreA 42-Year-Old Woman with Short-Term Dizziness and Vomiting
Case This 42-year-old woman presents to your urgent care center with a 2-hour history intermittent dizziness and vomiting. She denies diarrhea or exposure to ill persons. Further history reveals that she has recently had some epigastric discomfort. In the exam room, she is alert and oriented. She seems comfortable, in fact. In addition, you find: Lungs: Minimal bilateral symmetric wheezing Cardiovascular: Regular rate and rhythm without murmur, rub, or gallop Abdomen: Soft and nontender without …
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