Cardiovascular Medicine Question 98

A 42-year-old woman is evaluated for episodes of palpitations that last several seconds in duration. They occur once or twice a month and are accompanied by lightheadedness and mild dyspnea. She has not experienced loss of consciousness. The episodes are not precipitated by any particular activity, including exercise. She takes no medications.

On physical examination, the patient is afebrile, blood pressure is 110/68 mm Hg, pulse rate is 72/min, and respiration rate is 16/min. BMI is 29. Cardiac examination reveals physiologic splitting of S2, regular rate and rhythm, and no gallop. Estimated central venous pressure is normal. She has no edema. Serum thyroid-stimulating hormone level is normal.

A 12-lead electrocardiogram shows normal sinus rhythm.

Which of the following is the most appropriate diagnostic testing option?

A  30-Day wearable loop recorder

B  Echocardiogram

C  Exercise treadmill stress test

D  48-Hour ambulatory electrocardiographic monitor

E  Implantable loop recorder

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