Case No. 67

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Case No. 67


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Chief Complaint:

Palpitations while cleaning the house

Published: Aug. 2, 2017
Author: M00se

82 y/o male patient presents to the ED complaining about a sudden onset of palpitations while cleaning the house. Patient has a history of a TIA 2 months ago (treated) but, no other known medical history.. The patient is diaphoretic, alert and oriented X3. He is immediately hooked up to the monitor, a set of vitals, a 12 lead ECG as well as IV access is obtained. Vitals are as follows: BP: 110/80 RR: 25 Saturation: 98% HR: 200 beats/min Temp: 37 Celsius The results of the ECG are shown in the attached media (note the rate is not up to scale). After a few minutes, another set of vitals are taken with no improvement. You also notice a slight confusion when talking with the patient.


What should be the first step in the treatment of this patient?

  • Carotid Sinus Massage
  • Valsalva Maneuver
  • Adenosine 6mg
  • Wait and observe

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