USMLE Question of the Week
Evaluating Palpitations in a Young Woman
In Episode 16 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question: A previously healthy 25-year-old woman comes to the ED with complaints of several episodes of palpitations that began a couple of days ago. The palpitations are intermittent with each episode lasting 5 to 15 seconds. She feels like her heart is pounding and thinks her chest feels tight. There is mild dizziness associated with the longer episodes. She admits she has been staying up late to study for her medical school exams. She does not drink alcohol or use illicit drugs. She appears anxious. Her temperature is 37°C (98.6°F), pulse is 82/min, and blood pressure is 115/77 mm Hg. Physical examination shows no abnormalities. Which of the following is the most appropriate next step in management?
- Beta blocker
- Cardiac catheter ablation
- Electrical cardioversion
- Pharmacological cardioversion