Medical Council of Canada MCCQE Part 1 MCCQE Question # 64 Topic 7 Discussion
MCCQE Exam Topic 7 Question 64 Discussion:
Question #: 64
Topic #: 7
A 37-year-old woman presents to your clinic with frequent palpitations. She has no other symptoms and is quite active. Physical examination and resting electrocardiogram findings are normal. Which one of the following is the best next step?
The most appropriate next step for a patient with intermittent palpitations and a normal ECG is Holter monitoring (or event monitoring). This can capture and correlate symptoms with cardiac rhythm.
Toronto Notes 2023 – Cardiology, “Palpitations”:
“Holter or event monitoring is indicated when the initial ECG is normal but the patient has episodic symptoms such as palpitations.”
“Candidates must use ambulatory ECG monitoring to investigate intermittent palpitations when resting ECG is unremarkable.”
Echocardiogram (A) assesses structural issues but not rhythm. β-blockers (B) should not be started without diagnosis. Stress testing (D) is for ischemia.
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