[Answered]: Patient MA, a 72 year old Lithuanian male,…

Patient MA, a 72 year old Lithuanian male, presents to the emergency department with a 3-day history of intermittent palpitations, mild shortness of breath, and fatigue. He denies chest pain or syncope. He feels that the palpitations are constant but become worse when having dinner with his partner. He notes that within the last 2 days, he has experienced pre-syncopal symptoms, almost losing consciousness while re-arranging his attic with his boyfriend. Past Medical History: Hypertension (diagnosed 15 years ago) Type 2 Diabetes Mellitus Heart failure with preserved ejection fraction (HFpEF) CKD stage 3 (eGFR = 45 mL/min) Medications: Lisinopril 20 mg daily Metformin 1000 mg BID Furosemide 20 mg daily Aspirin 81 mg daily Vitals: BP: 138/86 mmHg HR: 128 bpm, irregular RR: 20/min O2 Sat: 95% on room air 1. Given the presentation above, what are some possible differential diagnoses? 2. A cardiology consult was called for the patient, and a diagnosis of atrial fibrillation is suspected. What follow up testing should be performed, and what would be some pathophysiologic findings on EKG to confirm this diagnosis? 3. Given the pathophysiology of atrial fibrillation, what would be your pharmacotherapy strategy? 4. Given the diagnosis of atrial fibrillation and his health history, should there be a consideration for anticoagulation therapy? If so, what options would you choose for this patient?