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A 69-year-old retired teacher presents with a 1-month history of palpitations, intermittent shortness of breath and fatigue She has a history of hypertension An ECG shows atrial fibrillation with a ventricula: rate of 122 per minute and sıgns of left ventricular hypertrophy She is anticoagulated wth warfarın and started on sustained-release metoprolol 50mg/d. After 7 days, the patient's rhythm reverts to normal sınus spontaneously However, over the ensuing month, she contnues to have intermittent palpitatons and fatıgue Continuous ECG recording over a 48-hour period documents paroxysms of atrial fibriilation with heart rates of 88-114 bpm An echocardiogram shows a left ventricular ejecton fraction of 38% with no localızed wail motion abnormality Questions: 1 What disease condition of the heart does the case presented? 2 What is a paroxysm? At this stage (referring to the last condition of the patient), would you initiate treatment with an antiarrythmic drug to maintain normal sinus rhythm, and if so, what drug would you choose and why? 3

A 69-year-old retired teacher presents with a 1-month history of palpitations, intermittent shortness of breath and fatigue She has a history of hypertension An ECG shows atrial fibrillation with a ventricula: rate of 122 per minute and sıgns of left ventricular hypertrophy She is anticoagulated wth warfarın and started on sustained-release metoprolol 50mg/d. After 7 days, the patient's rhythm reverts to normal sınus spontaneously However, over the ensuing month, she contnues to have intermittent palpitatons and fatıgue Continuous ECG recording over a 48-hour period documents paroxysms of atrial fibriilation with heart rates of 88-114 bpm An echocardiogram shows a left ventricular ejecton fraction of 38% with no localızed wail motion abnormality Questions: 1 What disease condition of the heart does the case presented? 2 What is a paroxysm? At this stage (referring to the last condition of the patient), would you initiate treatment with an antiarrythmic drug to maintain normal sinus rhythm, and if so, what drug would you choose and why? 3

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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Case study #1 A 69-year-old retired teacher presents with a 1-month history of palpıtations, intermittent shortness of breath and fatıgue She has a history of hypertension. An ECG shows atrial fıbrillation with a ventricular rate of 122 per minute and signs of left ventricular hypertrophy She is anticoagulated wth warfarın and started on sustained-release metoprolol 50mg/d. After 7 days, the patient's rhythm reverts to normal sınus spontaneously However, over the ensuing month, she contnues to have intermittent palpitatons and fatigue Continuous ECG recording over a 48-hour period documents paroxysms of atrial fibrillation wth heart rates of 88-114 bpm An echocardiogram shows a left ventricular ejecton fraction of 38% with no localızed wall motion abnormality Questions: 1 What disease condition of the heart does the case presented? What is a paroxysm? At this stage (referring to the last condition of the patient), would you initiate treatment with an antiarrythmic drug to maintain normal sinus rhythm, and if so, what drug would you choose and why? 3
Transcribed Image Text:Case study #1 A 69-year-old retired teacher presents with a 1-month history of palpıtations, intermittent shortness of breath and fatıgue She has a history of hypertension. An ECG shows atrial fıbrillation with a ventricular rate of 122 per minute and signs of left ventricular hypertrophy She is anticoagulated wth warfarın and started on sustained-release metoprolol 50mg/d. After 7 days, the patient's rhythm reverts to normal sınus spontaneously However, over the ensuing month, she contnues to have intermittent palpitatons and fatigue Continuous ECG recording over a 48-hour period documents paroxysms of atrial fibrillation wth heart rates of 88-114 bpm An echocardiogram shows a left ventricular ejecton fraction of 38% with no localızed wall motion abnormality Questions: 1 What disease condition of the heart does the case presented? What is a paroxysm? At this stage (referring to the last condition of the patient), would you initiate treatment with an antiarrythmic drug to maintain normal sinus rhythm, and if so, what drug would you choose and why? 3
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