Instructions
You are a medical student on placement in the cardiology clinic. Your next patient is Ray Thompson, 70, whose cardiologist has recommended amiodarone for atrial fibrillation. His baseline tests are below.
Take a focused history
Explain amiodarone and your management plan to the patient
Baseline tests (this week)
| Item | Value | Reference range |
|---|---|---|
| TSH | 2.1 mIU/L | 0.4-4.0 mIU/L |
| Free T4 | 15 pmol/L | 10-20 pmol/L |
| ALT | 28 U/L | 5-40 U/L |
| ALP | 70 U/L | 30-110 U/L |
| Potassium | 4.2 mmol/L | 3.5-5.0 mmol/L |
| INR | 2.6 | 2.0-3.0 (target on warfarin) |
| Digoxin level | 0.9 nmol/L | 0.6-1.3 nmol/L (therapeutic) |
| ECG | Sinus rhythm 72 /min; QTc 430 ms | QTc <450 ms (male) |
| Chest X-ray | Clear | - |
| Spirometry and gas transfer | Normal | - |