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  1. #1
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Which of the following is the most likely diagnosis?

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    A 20-year-old college student is evaluated for palpitations. She has noticed a rapid pounding in her chest on several occasions. She first noticed it in middle school. Most episodes last less than 1 minute, but a few have lasted one-half hour. During an episode, she feels lightheaded, but is not short of breath and does not have syncope or chest pain. She is most aware of the pounding sensation in her neck. Symptoms usually occur without warning while she is at rest. If she breathes slowly and deeply, the episodes usually stop on their own. They have never interfered with her activities, and she continues to run cross-country. Recently, the episodes have been longer and more frequent. She has never had the rhythm documented. Physical examination and electrocardiogram findings are normal. She has no family history of heart disease.
    Which of the following is the most likely diagnosis?
    A. Benign premature atrial contractions
    B. Palpitations related to mitral valve prolapse
    C. Paroxysmal supraventricular tachycardia
    D. Ventricular tachycardia
    E. Paroxysmal atrial flutter
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  2. #2
    winston's Avatar
    winston is offline Junior Member 510 points
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    is it a?.....

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    shygal122 is offline Newbie 510 points
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    I think the answer is B....she really has no electrocardiographic changes. Update on this later please.

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    hunteradam07 is offline Permanently Banned 511 points
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    Quote Originally Posted by shygal122 View Post
    I think the answer is B....she really has no electrocardiographic changes. Update on this later please.
    I think it's A, if she has MVP she musts have a midsystolic click on Ascultation findings and Syncope is also possible. Let me know if i m right.

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    Water's Avatar
    Water is offline Member 519 points
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    Quote Originally Posted by IMG SURVIVOR View Post
    A 20-year-old college student is evaluated for palpitations. She has noticed a rapid pounding in her chest on several occasions. She first noticed it in middle school. Most episodes last less than 1 minute, but a few have lasted one-half hour. During an episode, she feels lightheaded, but is not short of breath and does not have syncope or chest pain. She is most aware of the pounding sensation in her neck. Symptoms usually occur without warning while she is at rest. If she breathes slowly and deeply, the episodes usually stop on their own. They have never interfered with her activities, and she continues to run cross-country. Recently, the episodes have been longer and more frequent. She has never had the rhythm documented. Physical examination and electrocardiogram findings are normal. She has no family history of heart disease.
    Which of the following is the most likely diagnosis?
    A. Benign premature atrial contractions
    B. Palpitations related to mitral valve prolapse
    C. Paroxysmal supraventricular tachycardia
    D. Ventricular tachycardia
    E. Paroxysmal atrial flutter
    a) PAC is only a few beats; otherwise, it is svt
    b) Mitral valve prolapse would cause decrease cardiac output and morph change to heart and ecg.
    c) sounds like paroxysmal svt.
    d) VT will interfere with activities.
    e) Paroxysmal flutter does not cause palpitation unless it is with rvr. But rvr is often with afib not with flutter.

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