- Mood:

A 40-year-old man arrives at the ED with sudden-onset palpitations and shortness of breath. Paramedics observed a rapid heart rate on the cardiac monitor and associated rhythm strips; they administered adenosine 6 mg en route to the hospital. The patient had a momentary period of asystole, but his rapid heart rate returned. He reports increased stress at work and is drinking as many as 4 cups of coffee a day; additionally, he smokes 3 packs of cigarettes per week. An ECG is obtained. What is the diagnosis?
The answer is: atrial fibrillation. The first part of the heart is beating very fast and the heart looses about 30% of its power. It is like driving in the first gear on full speed. Does not feel well!
I am happy to say, that I got the diagnosis right whilst 30% of my colleagues got it wrong. 
Enjoy a happy and healthy life,
Dr Oliver Frey
PS: You can see the CME certificate here