A 55-year-old female is concerned about variations in her heartbeat. She describes 'fluttering,' 'flip-flopping,' and sometimes 'pounding' sensations in her chest, with occasional... A 55-year-old female is concerned about variations in her heartbeat. She describes 'fluttering,' 'flip-flopping,' and sometimes 'pounding' sensations in her chest, with occasional delays between beats. Her symptoms are episodic and have been occurring for several months, but were not present during the last week. The patient's family history is negative for thyroid disease, but she recalls some 'heart trouble' in several family members that was accompanied by fainting spells, and at least one relative died suddenly. She takes no medications, has a negative psychiatric review of systems, and has a normal physical examination. Which one of the following would be most appropriate at this point? A. Reassurance that her symptoms are associated with a benign condition B. A standard 12-lead electrocardiogram C. Echocardiography D. Intermittent event cardiac monitoring
Understand the Problem
The question presents a clinical scenario involving a 55-year-old woman with specific heart-related symptoms, and it asks which medical intervention or evaluation would be most suitable based on her symptoms and family history. The approach will involve assessing her condition and determining the best step to take at this point in her evaluation.
Answer
Intermittent event cardiac monitoring
Intermittent event cardiac monitoring would be most appropriate at this point.
Answer for screen readers
Intermittent event cardiac monitoring would be most appropriate at this point.
More Information
Intermittent event cardiac monitoring is useful for detecting episodes of arrhythmia when symptoms are not consistently present. Given the episodic nature of the symptoms, it's a strategic choice to capture any irregular heart activity that might occur unexpectedly.
Tips
One common mistake is opting for a standard 12-lead ECG, which might not capture episodic events since it records the heart's activity for a very short period.
Sources
- Heart palpitations - Symptoms & causes - Mayo Clinic - mayoclinic.org
- Heart Palpitations: Symptoms, Causes & Treatment - Cleveland Clinic - my.clevelandclinic.org
- Heart arrhythmia - Symptoms and causes - Mayo Clinic - mayoclinic.org
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