A pregnant woman with no significant medical history presented to an outpatient cardiology clinic for evaluation of intermittent, transient but rapid palpitations, some with momentary light-headedness. None lasted more than about 20 seconds, and there were no syncopal events. At no time did she note chest pain or dyspnea. There was no family history of dysrhythmia. There was no evidence of structural heart disease on physical examination, during which blood pressure was normal, and her pulse rate was 78/min. Baseline laboratory values were unremarkable, as was an echocardiogram. She was referred for a 24-hour Holter monitor. She was taking no medications, except prenatal vitamins. She had no history of smoking or recreational drug abuse, but drank 3 cups of coffee per day. Findings from the monitor are shown (Figure, A, B, and C).
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Michael P. Lavelle, MD, Columbia University Irving Medical Center, 177 Fort Washington Ave, Fifth Floor, New York, NY 10032 (email@example.com).
Published Online: May 22, 2023. doi:10.1001/jamainternmed.2023.0687
Conflict of Interest Disclosures: None reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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