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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 or swelling, pulses are 2+ and equal in all 4 extremities

View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

A 26-Year-Old Man with Palpitations