A 65-year-old woman with type 2 diabetes, hypertension, dyslipidemia, and obesity presented to her primary care clinician with 2 months of worsening dyspnea on exertion. Her medications included lisinopril, aspirin, and atorvastatin. Her vital signs were within normal limits, and her cardiac and respiratory examinations were unremarkable. Routine laboratory evaluation revealed an elevated blood glucose level; her basic metabolic panel, thyroid-stimulating hormone, and B-type natriuretic peptide levels were all within normal limits. A 12-lead electrocardiogram (ECG) demonstrated normal sinus rhythm with narrow QRS complexes. Given the patient’s symptoms of dyspnea on exertion, an exercise treadmill test (ETT) was performed to evaluate for coronary artery disease (CAD) (Figure).
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Muniyappa A, Padmanabhan A, Goldschlager N. A Wide Complex Tachycardia in a Woman During ExerciseDid She Tread Into Dangerous Territory?. JAMA Intern Med. Published online November 12, 2018. doi:10.1001/jamainternmed.2018.6207
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