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Case 1


Rapid Heart Rate and Shortness of Breath in a 40-Year-Old Man

BACKGROUND

A 40-year-old man arrives at the ED with sudden-onset palpitations and shortness of breath. Paramedics had observed a rapid heart rate on the cardiac monitor and associated rhythm strips; they administered adenosine 0.6 mg en route to the hospital. The patient had a momentary period of asystole, but his rapid heart rate returned. He reports increased stress at work and is drinking as many as 4 cups of coffee a day; additionally, he smokes 3 packs of cigarettes per week. An ECG is obtained.





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