Case Study

A 60-year-old man, W.S., comes to your office for a wellness visit. He is originally from India and has lived in the United States for more than 40 years. He has a history of hypertension, has never smoked, and has no history of stroke. He is current with preventive services, including vaccinations, appropriate cancer screenings, and counseling for healthy diet and physical activity; his hypertension is well controlled; and he is not experiencing any adverse symptoms. His 87-year-old father recently experienced a nonfatal stroke and was subsequently diagnosed with atrial fibrillation (AF), to which the stroke was attributed. W.S. is concerned about his risk of AF and asks you about available screening tests.

Case Study Questions

1. According to the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for AF, how should you proceed with this patient?

• A. W.S. is not in the population covered by the USPSTF recommendation.

• B. W.S. should be screened with electrocardiography (ECG) because of his family history and higher risk of AF.

• C. W.S. should not be screened because the harms of screening outweigh the benefits.

• D. W.S.'s risk of AF will increase as he ages; thus, he should be screened on a later date.

• E. There is insufficient evidence to evaluate the balance of benefits and harms of screening for AF in this patient.