Palpitations Case 1

Palpitations Case 1

A 32-year-old man presents having experienced a 2 hour episode of palpitations which he describes as fast and regular. During the episode he felt anxious but not otherwise unwell. He is not on any medication and denies recreational drug use. There is no significant family history, he smokes and works in a pub/nightclub.

Examination is normal at presentation.

  1. 1. Question

    Which one of the following is the key initial investigation?

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  2. 2. Question

    What is the likely underlying diagnosis?

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  3. 3. Question

    List the two key abnormalities on the ECG above which indicate this?

  4. 4. Question

    Which arrhythmia is the most likely cause of this patient’s palpitations?

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  5. 5. Question

    This patient requires admission for observation, investigation and control of symptoms; is this true or false?

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  6. 6. Question

    You decide to discharge the patient with cardiology follow-up for further investigation.

    What 3 pieces of advice would you give the patient on discharge?