11-20-2006, 03:55 PM
24 y/o M c/o off and on palpitations for the past one week. He says the palpitations increase after exercise and climbing a flight of stairs. He denies any chest pain, breathlessness, dizziness, cough, nausea, vomiting. Past medical history is insignificant. He attributes his palpitations to coffee usage. He usually consumes two cups of coffee every morning but has stopped coffee for the past three days. His sleep is not disturbed and he is not under any emotional stress. Physical exam is within normal limits except a pulse rate of 113. He is afebrile. what is the next best step in management?
A) order a resting EKG
B) order an exercise EKG
C) order a chest x-ray
D) start a trial of low dose beta-blocker
E) reassure and examine in two weeks
A) order a resting EKG
B) order an exercise EKG
C) order a chest x-ray
D) start a trial of low dose beta-blocker
E) reassure and examine in two weeks