Cardiology Case Report: Palpitations at Golf

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This case report from Brady Pregerson, MD, features a man in his early 70s presenting to the hospital with palpitations for the past 2 hours that started while playing a round of golf. Can you determine the most likely rhythm?

History:

A patient in their early 70s presents to the hospital with palpitations for the past 2 hours that started while playing a round of golf. He feels dizzy, but denies vertigo, syncope, chest discomfort, leg swelling, fever, cough, or other complaints. He has no known medical history but does smoke tobacco.

Exam:

Vital signs are normal except for tachycardia. The physical exam is otherwise normal with clear lungs, no leg edema, and no nystagmus.

Computer printout of patient ECG. Computer Read: Sinus tach at 132, Non-specific intraventricular conduction delay

Computer Read: Sinus tach at 132, Non-specific intraventricular conduction delay.

Credit: Brady Pregerson, MD

What is the most likely rhythm in this patient?


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