A Coffee Drinker With Sudden-Onset Dyspnea, Tachycardia

Lemi Luu, MD

Disclosures

April 28, 2022

Physical Examination and Work-up

Upon physical examination, the patient is afebrile and has a heart rate of 165 beats/min and a blood pressure of 138/79 mm Hg. He appears well and is in no acute distress.

Findings on head and neck examination are unremarkable. The patient has no jugular venous distention. His heart rate is rapid and irregular, with an audible S1 and S2 and no gallops, rubs, or murmurs. His lungs are clear bilaterally. His abdomen is soft and nontender, and without masses. He has no peripheral edema. Results of his laboratory work-up, including a complete blood count (CBC), serum electrolyte and cardiac enzyme measurements, and a coagulation panel, are all normal. His chest radiograph findings are also normal.

An ECG is obtained (Figure 3).

Figure 3.

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