80 Year Old Female: “ Rapid Heart Rate ”

You are dispatched to a nursing home for an 80 year old female with a “rapid heart rate.” You arrive on scene and the charge RN gives you report. Per the RN, assistive staff were checking the patient’s vitals this morning when they noted her heart rate to be elevated. They consulted the RN, who found the patient to have a rapid and irregular pulse, so he in-turn consulted the nursing home physician, who requested the patient be transported to the community emergency department approximately 30 min away for further workup and management. When you walk in the room, you find a pleasant-appearing woman sitting in a chair and smiling at you. She is in no distress and her breathing is not labored. You check a pulse and note it to be fast and irregular, while her skin is of normal color and temperature. Vitals: HR: ~120 bpm SpO2: 96% on room air BP: 154/86 mmHg RR: 20 /min Temp: 36.7 C The patient initially denies any acute complaints, but upon further questioning admits that she has been feeling weaker than usual this morning, and short-of-breath on exertion. She also feels a bit lightheaded when she stands up, but attributes that to skipping breakfast. Yesterday she felt fine and was in her normal state of health. She denies any unusual pain or discomfort in her chest, back, or abdomen, though she suffers from chronic low back pain that is unchanged from baseline. No nausea or vomiting. No fevers or chills. No change in bladder or bowel habits. No recent falls ...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Cases Vince DiGiulio Source Type: research