AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
A 43-year-old man is evaluated for palpitations. He has no prior personal or family history of cardiovascular disease, diabetes mellitus, or hypertension. His cardiovascular examination is unremarkable with the exception of an irregular rapid heart rate. Lung examination is normal.
Laboratory testing, including thyroid function, is normal. The chest radiograph is normal. The electrocardiogram is shown (Figure 25). Based on his report and symptoms, it is suspected that the patient has been in this rhythm for approximately 5 hours. The patient converts to sinus rhythm spontaneously while in the emergency department, and the subsequent electrocardiogram is normal.
What is the most appropriate management plan for this patient?
A Outpatient anticoagulation B Inpatient anticoagulation with heparin C Transesophageal echocardiogram
D Aspirin
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
A 43-year-old man is evaluated for palpitations. He has no prior personal or family history of cardiovascular disease, diabetes mellitus, or hypertension. His cardiovascular examination is unremarkable with the exception of an irregular rapid heart rate. Lung examination is normal.
Laboratory testing, including thyroid function, is normal. The chest radiograph is normal. The electrocardiogram is shown . Based on his report and symptoms, it is suspected that the patient has been in this rhythm for approximately 5 hours. The patient converts to sinus rhythm spontaneously while in the emergency department, and the subsequent electrocardiogram is normal.
What is the most appropriate management plan for this patient?
A Outpatient anticoagulation
B Inpatient anticoagulation with heparin
C Transesophageal echocardiogram
D Aspirin
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
The EKG showed atrial fibrillation with rapid ventricular response
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
excellent case
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,393
|
C Transesophageal echocardiogram ??
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
wrong answer
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| NE
Forum Guru
Topics: 53
Posts: 504
|
From AHA guidelines:
"The need for anticoagulation in patients with short-duration AF (less than 48 hours) is less clear. These patients can have left atrial thrombi and systemic emboli. Administration of intravenous heparin before cardioversion and warfarin anticoagulation for 3 to 4 weeks after cardioversion may be useful, but supporting data are not available."
So I guess it is warfarin but is a very tricky q.
|
| sprint123
Forum Guru
Topics: 129
Posts: 870
|
Low risk patients for Stroke-No need warfarin ...ONLY ASPIRIN
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
Sprint123, Correct
Please understand how to deal with low risk patients without structural heart disease.
This pt is 43 years old, unlikely to have severe structural heart disease. So ASA is fine
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
|
| |
| | | | | | | | | |
Similar forum topics