A 50-year-old female presents to the clinic with complaints…
A 50-year-old female presents to the clinic with complaints of intermittent palpitations that have been occurring for the past month. She describes the palpitations as a “fluttering” or “racing” sensation in her chest, lasting for 1-2 minutes at a time, occurring primarily at rest or during times of increased stress. She denies chest pain, dizziness, or shortness of breath. Her medical history includes hypertension, obesity, and a 15-pack-year smoking history. She takes an ACE inhibitor for her hypertension and uses over-the-counter caffeine-containing products regularly. Her family history is significant for heart disease, with her father having a myocardial infarction at age 55. On examination, her blood pressure is 135/85 mmHg, heart rate is 78 bpm, and her physical exam is otherwise unremarkable. Which is most likely contributing to this patient’s palpitations?
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