a 68 year old male presents with palpations, light headiness and weakness. these symptoms appear to worsen with
increased alcohol intake. Medical history is significant for hypertension being treated with hydrochlorothiazide. on physical exam, the patient appears uncomfortable. There is an irregularly irregular pulse when palpating the radial artery. on cardiac auscultation, the first heart sound S1 is of variable intensity. There is mild bibasilar crackles on pulmonary auscultation and an absence of peripheral edema. An electrocardiogram is obtained. What is your diagnosis? what is the treatment plan.
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