A young female with palpitations

A female aged 33 years Chief Complaints Anxiety Palpitations Diaphoresis (x 2 hrs) Vitals BP- 98/60mmHg Investigations ECG


Atrial fibrillation with rapid ventricular rate. Intermittent flutter Waves seen.

Ecg -shows heart rate 150-160/mt and saw teeth appearance and atrial fibrillation which may lead to psvt.B blocker or calcium channel blocker or digitalis may be used. When pt is haemodynamically stable underlying cause must be sorted out. Advise-1-cabg. 2-2D echo. 3-cardiac biomarker biochemistry. 4-troponin 1 and troponin T. Treat pt as per reports in critical cardiac unit essential.

A. Fib with RVR

AF with FVR Immediate rate control with IV betablocker since hemodynamically stable and anticoagulation to prevent stroke. Since she is young, possibility of structural heart disease, RHD, electrolyte disturbance, thyroid and medication history to be considered.

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