A 62 year old woman visits her physician for a routine physical examination. She has a long history of arthritis in the back and she takes ibuprofen as needed. . She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? A- Reassurance and follow up visits B- Repeat Holter monitor examination C- Perform exercise stress test D- Pacemaker implantation E- Refer to a cardiologist Answer
