Palpitations Options A Atrial fibrillation B Complete heart block C Supraventricular tachycardia D Ventricular ectopic E Ventricular fibrillation F Ventricular tachycardia G Wenckebach phenomenon 42 A 76-year-old man is on the coronary care unit two days after an acute myocardial infarction. He tells you that he has had an episode of rapid pounding in his chest lasting for about a minute. He remained conscious throughout. 43 A 68-year-old man on treatment for an irregular heartbeat comes to the Accident and Emergency Department. He has had palpitations for the last three hours. On Examination you find that his pulse is regular and is 154 beats/minute. Carotid sinus massage settles his pulse down to 80 beats/minute. 44 A 70-year-old woman with longstanding anxiety is seen in the out patients department. She complains of her heart ‘skipping a beat’ quite often. This particularly occurs when she is trying to get to sleep. The palpitations are never sustained. 45 A 28-year-old man presents with a two-hour history of rapid palpitations. He feels a little lightheaded but is otherwise well. On examination, his pulse is 170 beats/minute and regular and blood pressure is 100/68-mmHg. He has had two similar episodes in the past. 46 A 74-year-old man with angina presents feeling unwell with a history of slow pounding in his chest. His angina has been worse lately and he has been prescribed diltiazem.