A 34-year-old man presented to the doctor with complaints of heart palpitations, dizziness, and presyncope. The heart palpitations started more than 1 week prior, and the dizziness and presyncope began earlier that day. The patient noted that the palpitations were worse after drinking a few cups of coffee in the morning. Prior to his presentation, he had undergone a significant amount of emotional stress related to work and a continuous lack of sleep. Physical examination showed patient had a normal blood pressure of 118/64 mm Hg. Electrocardiogram (ECG) showed tachycardia (180 beats/min). Social history included smoking and alcohol use. Patient denied illicit drug use but admitted to a recent increase in alcohol use (3-4 drinks daily). He had no previous history of cardiac conditions.
What’s the diagnosis?
- Acute coronary syndrome
- Atrial flutter
- Generalized anxiety disorder
- Paroxysmal supraventricular tachycardia
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