A 25-Year-Old Man Arrives at the Emergency Department Complaining of Chest

A 25-year-old man arrives at the emergency department complaining of chest pain and palpitations for the past three hours. He'd had similar episodes in the past year that were resolved with deep breathing, but none had lasted as long as this one. The patient does not have any chronic medical conditions and does not take any medications. He does not smoke, drink alcohol, consume caffeine, or use illegal drugs. The blood pressure is 100/70 mm Hg, and the pulse rate is 160 beats per minute. The neck is flexible, the thyroid is functioning normally, and there is no lymphadenopathy. Auscultation reveals that the lungs are clear. ECG is shown in the exhibit.  Which of the following is the most likely cause of this patient's symptoms?

A) Abnormal conduction in areas of ischemic ventricular scarring
B) Abnormal conduction through the atrioventricular node
C) Atrial remodeling with ectopic foci in the pulmonary vein ostia
D) Degeneration of the sinoatrial node
E) Delayed repolarization of ventricular cardiomyocytes

Correct Answer:

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