A 65-Year-Old Man Comes to the Emergency Department 1 Hour

A 65-year-old man comes to the emergency department 1 hour after a loss of consciousness. His wife said he suddenly fainted while she was adjusting his necktie. He regained consciousness within 30 seconds and was fully alert and oriented. He has had two similar episodes in the last year. His temperature is 37.2°C (98.9°F) , pulse is 70/min and regular, respirations are 13/min, blood pressure is 130/82 mm Hg when supine and 122/80 mm Hg while standing.  Physical examination reveals no heart murmurs or carotid bruits.  ECG shows normal sinus rhythm.  The patient is given an ambulatory ECG monitoring device.  During symptomatic episodes, the device is most likely to show which of the following?

A) Atrial fibrillation
B) Mobitz type II second-degree heart block
C) Paroxysmal supraventricular tachycardia
D) Sinus pause
E) Ventricular tachycardia

Correct Answer:

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