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Key History -
Gradual vs. acute onset/offset

context –
exertion
caffeine
anxiety

associated Sxs –
lightheadedness
chest pain
dyspnea

hyperthyroid Sxs
h/o bleeding or anemia
h/o heart disease
Key PE -
VS
endocrine/thyroid exam-
include exophthalmos
lid retraction
lid lag
gland size
bruit
tremor

complete CV exam
70 y/o diabetic M
presents with episodes of palpitations
and diaphoresis.
He is on insulin

What is Differential?
Hypoglycemia

cardiac arrhythmias
angina
hyperthyroidism
hyperventilation episodes
panic attacks
pheochromocytoma
carcinoid
70 y/o diabetic M
presents with episodes of palpitations
and diaphoresis.
He is on insulin

What is Workup?
Glucose
CBC, electrolytes
TSH
BUN/Cr
EKG
holter monitor
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