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JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROACH FOR ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE (HEART POUNDING) – A 2024 CASE STUDY FOR ACUTE PALPITATIONS AND SHORTNESS OF BREATH.$22.99
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JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROAC
JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROAC
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JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROACH FOR ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE (HEART POUNDING) – A 2024 CASE STUDY FOR ACUTE PALPITATIONS AND SHORTNESS OF BREATH.
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JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROAC
Institution
JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROAC
JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC APPROACH FOR ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE (HEART POUNDING) – A 2024 CASE STUDY FOR ACUTE PALPITATIONS AND SHORTNESS OF BREATH.
JOSEPH MARTINEZ: MANAGEMENT AND DIAGNOSTIC
APPROACH FOR ATRIAL FIBRILLATION WITH RAPID
VENTRICULAR RESPONSE (HEART POUNDING) – A 2024 CASE
STUDY FOR ACUTE PALPITATIONS AND SHORTNESS OF
BREATH.
REASON FOR ENCOUNTER :"heart pounding x 3 days" and shortness of
breath.
bp 150/100 HR 136
1. What labs and test would you order?
2. Medications? IVP Metoprolol, Cardizem drip or Amio drip
Start Heparin drip or PO eliquis
Chief Complaint
• Heart pounding for 3 days: Ask the patient to describe the
sensation (e.g., racing heart, fluttering, irregular beats).
• Shortness of breath: Clarify the onset, duration, and exacerbating
or relieving factors.
History of Present Illness (HPI)
1. Onset and Duration:
o When did the heart pounding and shortness of breath start?
o Was the onset gradual or sudden?
o Has this ever happened before, or is this the first episode?
2. Character and Symptoms:
, o Is the heart pounding continuous or intermittent?
o Can the patient feel an irregular heartbeat, or does it feel
rapid but steady?
o Any associated chest pain, dizziness, or lightheadedness?
o Is the shortness of breath worse with exertion or at rest?
o Any orthopnea (shortness of breath when lying flat) or
paroxysmal nocturnal dyspnea (waking up breathless)?
3. Severity:
o How severe is the discomfort or shortness of breath? Can
the patient still walk or perform daily activities?
4. Progression:
o Has the heart pounding worsened or remained stable over
the past 3 days?
o Has the shortness of breath changed, worsened, or
improved?
5. Aggravating/Alleviating Factors:
o What makes it worse (physical activity, stress)?
o What relieves the symptoms (rest, medications)?
6. Associated Symptoms:
o Chest pain (suggesting ischemia or angina)?
o Palpitations (sensation of irregular or rapid heartbeat)?
o Dizziness or syncope (suggestive of poor perfusion)?
o Fatigue or generalized weakness?
, o Cough or leg swelling (suggestive of heart failure)?
o Nausea, vomiting, or diaphoresis (suggestive of myocardial
ischemia)?
Past Medical History (PMH)
1. Cardiac History:
o History of atrial fibrillation, arrhythmias, heart failure,
coronary artery disease, myocardial infarction, or valvular
heart disease?
o Previous episodes of palpitations or heart pounding?
o Any history of hypertension (likely given the elevated BP of
150/100), and how well controlled is it?
o Hyperlipidemia or history of high cholesterol?
2. Respiratory History:
o History of chronic obstructive pulmonary disease (COPD),
asthma, or recent respiratory infections?
o Any history of pulmonary embolism or other lung-related
issues?
3. Endocrine History:
o Diabetes or thyroid disorders (hyperthyroidism can cause
tachycardia and palpitations)?
4. Stroke/Thromboembolic History:
o Previous stroke, transient ischemic attack (TIA), or deep
vein thrombosis (DVT)?
o History of being on anticoagulation in the past?
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