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You are seeing an 18 year old male who presents with palpitations. Electrocardiogram reveals atrial fibrillation with a rapid ventricular response rate at 145.
Kelly September 14, 2021 - 2:52 pm
E) All of the above
Atrial fibrillation is much less common in young patients compared to older adults. Unlike elderly, atrial fibrillation in young patients is more likely to be paroxysmal and symptomatic, presenting with chest pain and/or palpitations. Risk factors include all those listed, plus hypertension, diabetes, smoking, alcohol, + family history, GERD, endurance exercise, and autonomic stimuli (vagal or adrenergic). Work-up in the ED includes a careful H&P, family and social history, ECG, and tests of thyroid, renal, and hepatic function, and echocardiogram if readily available.