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Medicine
A 22-year-old woman is evaluated in the emergency department because of symptoms of prolonged palpitations. She complains of no associated chest discomfort, shortness of breath, or lightheadedness. The palpitations have occurred twice before, but they always stopped spontaneously after 5 minutes, and she cannot associate them with any triggers. The past health history is negative and she is not on any medications.On physical examination, the blood pressure is 110/70 mm Hg, heart rate is 160/min and regular. The heart and lung examinations are normal, and the ECG is shown in Figure below. The heart rate abruptly changes to 72/min after applying carotid sinus pressure. Which of the following is the most likely diagnosis?
sinus tachycardia
paroxysmal atrial fibrillation
paroxysmal atrial flutter
paroxysmal supraventricular tachycardia (PSVT)
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