Abstract:A 63 year old white man with hypertension presents complaining of episodes of light headedness and generalized weakness, in the last year, more frequent in the last few weeks. He has noticed an overall decline in heart rate (HR) while exercising on treadmill. Atenolol dose was decreased a month ago with no improvement. Physical exam revealed a right sided goiter, otherwise unremarkable. Labs, EKG, Stress test and Echocardiogram were within normal limits. No pauses on the monitor. Carotid massage revealed a sig… Show more
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