arrhythmias/sinus tachycardia

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683c98b6bf0c2b5ee08e4a53

Cardiology

arrhythmias

sinus tachycardia

A 64-year-old woman is admitted to the medical ward presenting with a 4-day history of escalating fever, profound dizziness, and recurrent vomiting. She reports inability to tolerate oral intake and persistent temperatures exceeding 38.5°C despite home remedies. Accompanying symptoms include generalized malaise, rhinorrhea, nasal congestion, and a mild, non-productive cough. Her medical history includes well-controlled essential hypertension. On examination, she appears acutely ill and lethargic. Her vital signs are notable for a blood pressure of 90/60 mm Hg, a pulse rate of 118 beats/min, respiratory rate of 20 breaths/min, and an oral temperature of 39.1°C. Physical examination reveals dry mucous membranes, reduced skin turgor, and a capillary refill time of 4 seconds. Cardiopulmonary auscultation is unremarkable save for the regular, rapid heart rate. Rapid molecular testing for respiratory pathogens confirms the presence of influenza A virus. Considering her current clinical state, what is the most appropriate initial diagnosis and subsequent management plan?

Lab ParameterValueReference Range
White Blood Cell Count13.5 x 10^9/L4.0-11.0 x 10^9/L
Hemoglobin135 g/L120-150 g/L
Platelets280 x 10^9/L150-450 x 10^9/L
Sodium148 mmol/L135-145 mmol/L
Potassium4.1 mmol/L3.5-5.0 mmol/L
Chloride108 mmol/L98-107 mmol/L
Bicarbonate20 mmol/L22-29 mmol/L
Blood Urea Nitrogen (BUN)10.5 mmol/L2.5-8.0 mmol/L
Creatinine110 µmol/L45-90 µmol/L
Urine Specific Gravity1.0301.005-1.030

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