A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits.
What is the best management for this patient at this point? #usmle #medicine
A- Reassurance and follow up visits
B- Repeat Holter monitor examination
C- Perform exercise stress test
D- Pacemaker implantation
E- Refer to a cardiologist