A 55-year-old woman with a history of anxiety and hypertension complains of palpitations increasing in frequency over the past week. She is under considerably more stress at work, with job cuts looming for several employees. Her last episode was typical of her previous – it lasted two to three minutes while she was at her desk: “my heart was pounding so badly it went up my neck and into my head!” She has no complaints of chest pain, shortness of breath, nausea, or diaphoresis with these episodes. The remainder of her history is unrevealing and her vital signs and physical examination are normal. Her electrocardiogram (ECG) in the ED is normal.
Regarding this patient’s risk for an arrhythmia, which of the following is the BEST answer:
A. Her history puts her at high risk for a significant arrhythmia
B. A normal examination and a normal ECG in this patient make a clinically significant arrhythmia much less likely
C. Her lack of high risk symptoms places her at low to moderate risk for an arrhythmia
D. Her history of anxiety should be pursued further .
In the meantime, a quote -- "Your prayer must be for a sound mind in a sound body (mens sana in corpore sano)." -- Juvenal, Roman satirist, c. AD 60-130
Regarding this patient’s risk for an arrhythmia, which of the following is the BEST answer:
A. Her history puts her at high risk for a significant arrhythmia
B. A normal examination and a normal ECG in this patient make a clinically significant arrhythmia much less likely
C. Her lack of high risk symptoms places her at low to moderate risk for an arrhythmia
D. Her history of anxiety should be pursued further .
In the meantime, a quote -- "Your prayer must be for a sound mind in a sound body (mens sana in corpore sano)." -- Juvenal, Roman satirist, c. AD 60-130
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