A 61 year-old-man has been referred to the outpatients department with frequent episodes of breathlessness and chest pain associated with an irregular heartbeat. He has a regular pulse rate of 60beats/minute. His ECG shows sinus rhythm.
A. Cardiac enzymes
B. Electrocardiogram
C. Echocardiogram
D. 24 hour ambulatory taped electrocardiogram
E. Serum urea and electrolytes concentration
Ans. The key is D. 24 hour ambulatory taped electrocardiogram. [Possibility of paroxysmal atrial fibrillation where pulse is quiet normal in between attacks. So to demonstrate arrhythmia 24 hour ambulatory taped electrocardiogram should be done