Case Report

The patient is a 50-year old man with Hepatitis C, HIV, and pneumonia who recently became homeless and presented with 3 days of worsening palpitations and shortness of breath.Initially the palpitations were sporadic; however, they had become more frequent over the three days prior to admission.He had a corresponding increase in shortness of breath along with significant decreases in his exercise tolerance. He presented to the Emergency Department (ED) when he could no long perform his usual activities of daily living. In the ED, patientwas found to have a narrow complex tachycardia with a rate of 234 beats per minute (bpm) (Figure 1).