Clinical Challenge 2: October 2017

A 42-year-old woman with a history of anxiety presents, complaining of intermittent palpitations over the past 2 weeks. She says she has not taken any medication and denies chest pain, shortness of breath, diaphoresis, fever, or dizziness.

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 diagnoses and next steps would be. Resolution of the case is described on the next page.