QuestionSBA
QuestionChoice
Atrial fibrillation is characterised by irregular, uncontrolled electrical activity in the atria of the heart. This can be seen on the ECG as an absence of P waves and an irregularly irregular rhythm. The patient has been experiencing palpitations and dizziness which are also symptoms of atrial fibrillation.
10027491
a
Atrial Fibrillation
QuestionChoice
This is incorrect. Ventricular fibrillation is a life-threatening arrhythmia whereby the ventricles contract in an uncoordinated manner. Blood ceases to be pumped around the body, thus resulting in a cardiac arrest. Ventricular fibrillation is classed as a "shockable" rhythm that can respond well to defibrillation. It is characterised by rapid fibrillation waves of varying amplitude with no discernible P, QRS or T waves.
10027493
c
Ventricular Fibrillation
QuestionChoice
This is incorrect. Although patients with atrial fibrillation commonly experience palpitations, in atrial flutter the electrical activity in the atria is coordinated. This leads to a rapid atrial rate and a reduced ventricular rate leading to the characteristic flutter or 'sawtooth' waves seen on an ECG.
10027492
b
Atrial Flutter
QuestionChoice
This is incorrect. Ventricular tachycardia is a medical emergency. It can be pulsed or pulseless (i.e. when in cardiac arrest) and needs immediate management. Ventricular tachycardia would present on an ECG with a broad QRS complex and a rate greater than 100 beats per minute.
10027495
e
Ventricular Tachycardia
QuestionChoice
This is incorrect. Anxiety and panic attacks can present with dizziness and palpitations, however, the pulse would be regular and the ECG would show a normal sinus rhythm.
10027494
d
Anxiety
Concept
Chapter
2693
3714
Atrial fibrillation
Topic
134
Cardiology
17896
Picture
2311
ECG_Atrial_Fibrillation_98_bpm.jpeg
images/vcba5s1r1701430385899.jpg
images/vcba5s1r1701430385899_256.jpg
images/vcba5s1r1701430385899_512.jpg
OSgCA4ArlxyZovckR4aAdAc=
Topic
134
Cardiology
A 78 year old female attends the GP complaining of intermittent palpitations and dizziness for the past three months. She describes the palpitations as a fluttering in her chest, as if her heart has skipped a beat. She feels lightheaded during these episodes.

The only past medical history of note is hypertension for which she takes amlodipine.

On examination the patient appears comfortable at rest and her pulse is irregularly irregular. The GP decides to take an ECG, as shown below. [lightgallery]

Which of the following is the most likely diagnosis?
a