A 68-Year-Old Man Comes to the Emergency Department Due to Palpitations

question 1040

Multiple Choice

A 68-year-old man comes to the emergency department due to palpitations accompanied by mild dizziness and sweating.  The symptoms started abruptly 30 minutes ago.  He has had no chest pain or shortness of breath.  Medical history is significant for hypertension and a myocardial infarction 6 months ago.  The patient is an ex-smoker with a 30-pack-year history.  Blood pressure is 102/65 mm Hg and pulse is 160/min and regular.  Oxygen saturation is 98% on 2 L nasal cannula oxygen.  On physical examination, prominent, high-amplitude jugular venous pulsations are seen intermittently at irregular intervals.  ECG reveals a regular, wide-complex tachycardia.  Which of the following best explains the patient's physical findings?

• A)Aortic regurgitation
• B)Atrial fibrillation
• C)Atrioventricular dissociation
• D)Pericardial effusion
• E)Tricuspid regurgitation

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