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Case Study: 31-year-old female with cardiac arrhythmia

History of present illness: A 31-year-old overweight Caucasian female presents post-emergency room with sporadic bursts of increased heart rate while at rest. She reports that it was discovered incidentally during an urgent care visit for a sore throat. She notes two staff nurses unsuccessfully attempted to measure pulse using a pulse oximeter and then attempted manual methods, but said that the rate was too fast for them to read. After slowing down enough for the pulse oximeter to function, heart rate was at 260. Patient was given an EKG and then referred to the emergency room. The EKG taken at urgent care as well as in emergency room showed an inconsistently abnormal P wave or an abnormal QRS wave, which was either reduced or heightened. A full cardio work-up including echocardiogram and stress test came out negative. She is otherwise healthy. Patient denies any recent illness, weight loss or gain, and changes in stress level or activity level.

Social history: Patient denies tobacco use. She denies alcohol and illicit use. She is single. She is self-employed in marketing. She has a dog.

Allergies: Soy.

Past medical history: Pseudotumor cerebri.

Medications: None.

1. How would you monitor this patient, moving forward?