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A young woman with palpitations
  1. A A Khasnis,
  2. S C Kantipudi,
  3. R K Thakur
  1. 1Michigan State University, 405 West Greenlawn, Suite 400, Lansing, M1 48910, USA
  1. Correspondence to:
 Dr Ranjan K Thakur; 
 thakur{at}msu.edu

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Answers on p 483.

A 30 year old woman presented with paroxysmal episodes of palpitations that she had had for two years. Initially the episodes occurred 3–6 months apart but they had become more frequent before presentation. Occasionally, the episodes were associated with pre-syncope. She described her palpitations as regular and rapid. She had no other past significant medical history. Examination of the cardiovascular system was normal. She had no clinical evidence of hyperthyroidism or thyroid enlargement. All laboratory investigations were normal. Her electrocardiogram (ECG) taken at rest is shown in fig 1.

QUESTIONS

  1. What does the ECG show?

  2. What should be the next step in management?

  3. Is this patient at risk for sudden death? If yes, how will you evaluate her for this risk?

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