CaseStudy 2 _19112016 - Case of new atrial fibrillationCreated by:
An elderly woman, with history of hypertension, previous ischameic heart disease, previous stroke, peripheral vascular disease, osteoporosis, mild cognitive impairment, chronic kidney disease, and recently diagnosed metastatic breast cancer, was admitted to hospital due to sudden onset of palpitation, chest heaviness, and minimal shortness of breath. On arrival, patient was having fast atrial fibrillation (new), with the rate around 130-140 per minute, with blood pressure of around 150/90. Her oxygenen saturation was around 96% on room air. ECG showed fast atrial fibrillation. Chest X-ray showed no consolidation, urine dipstick was normal. Blood tests showed normal full blood count, normal CRP, stable renal function, with normal eletrolytes, normal thyroid function test and liver function test. Troponin level is elevated of twice the normal value. What is your differential diagnosis ? What is your treatment, investigation and management plan ??