Case Studies

A 57 year-old black male patient presenting to the office for a scheduled appointment. Vitals are as follows: BP 131/55; heart rate 155; temperature 98.0 F; O2 Sat 94%. Patient states, “I Feel fine”. Denies shortness of breath, chest pain, nausea, and vomiting, or recent diarrhea. Past medical history is multiple Myeloma, HTN, Anemia, and ESRD with dialysis MWF. Patient admits to smoking 5 minutes prior to vitals being checked.

1. What labs or procedures are you running to confirm your diagnosis?

2. What is your diagnosis?

3. What are your recommendations for the patient?

4. What EKG rhythm would be least concerning?

 No P-wave, no PR interval, and no QRS duration

 No P-wave, we are in the world not measurable, QRS duration absent

 P-wave saw tooth flutter, PR not measurable, QRS duration less than 0.1 sec

 P-wave uniform/uniform, PR interval 0.12 to 0.20 sec/consistent, and QRS duration 0.10 sec or less

5. Which non-invasive procedure would you expect the emergency facility to initiate?

 Cardiac Ablation

 Epinephrine

 Valsalva maneuver

 Adenosine

6. Which medication would you expect the patient to be taking on the next visit?

 Losartan

 Clonidine

 Hydrochlorothiazide

 Dilitazem

7. What are some of the main foods to avoid with SVT?

 High fructose corn syrup

 Spinach

 Earl gray tea

 Anchovies

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