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Case 3 Answer

The correct answer is C. Medically unexplained symptom (MUS) is most likely. The multiple choices were: A. Premature ventricular beats, B. Paroxysmal supraventricular tachycardia, C. Medically unexplained symptom, D. Hyperthyroidism, E. Junctional rhythm

Explanation: About 15% of patients experiencing palpitation (an unpleasant throbbing sensation in the chest) have no discernable medical disorder and are said to have a medically unexplained symptom or MUS*. About 40% of patients with palpitation have a momentary, paroxysmal, or fixed arrhythmia such as atrial fibrillation or premature atrial or ventricular beats. Drugs, anxiety, and a variety of systemic and cardiac disorders may also give rise to palpitations in the absence of an arrhythmia.

* MUS can range from a mild and transient symptom to a persistent and psychologically disabling disorder such as somatisation or hypochondriasis.

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