‘Skipping beats’

Scenario: A 77-year-old white male comes into your office complaining of feeling dizzy, short of breath, easily fatigued and having a sensation of his heart ‘skipping beats’. • He reports he has had these same symptoms numerous times over the last year or so, but they only lasted for about a day. • He thought since he has been experiencing them now for about 3 days he should come in and get checked out. • He was diagnosed with type 2 diabetes twenty years ago and hypertension fifteen years ago. • Current medications include Lisinopril 20 mg daily and Metformin 1000 mg daily. • BP 172/100, P 123 irregularly irregular, R 20 • Skin is warm, pale with a slight gray cast; lungs are clear to auscultation; heart irregular rhythm Please develop a discussion that responds to each of the following prompts.