You
are in your office. The next patient is here and He is a healthy
51 year old male with no significant medical history. He exercises
regularly, eats only organic vegetables and non-steroid raised meats,
does not smoke, and both his parents are living ate the ages of
91 and 85 with only one with Alhzeimers Dementia and no Cardiac
disease history. He is here for his regular yearly visit. You ask
him if he has any complaints. He says, "You know, sometimes
I feel my Heart Jump out of my chest". He states this happens
maybe a few times a day, more often when he drinks a lot of his
special Herbal tea which does have a lot of caffeine in it. He is
a little concerned and is wondering if it means anything.
You begin your
exam. Everything is with in normal limits, except for a few positive
findings which include, Jugular Venous Pulse with 2 waves at regular
intervals and an occasionally appearing large wave, A pulse that
feels slightly irregular, and on auscultation of the precordium
frequent irregularity which is difficult to determine if it's regular
or always irregular. You decide this warrants an EKG to make sure
he is not in Atrial fibrillation. The Rhythm strip from an EKG is
below. First, what do you tell the patient, and second how do you
correlate the physical findings with the EKG findings.
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