A 21-year-old man was brought to the emergency department due to dizziness and palpitations that started abruptly an hour ago. He has had similar episodes that provoked fatigue or strong emotions. The patient can usually stop the episodes by squatting and taking a deep breath. However, this time, these actions didn't work. His blood pressure is 65/40 mmHg, and his pulse is 240/min. He is diaphoretic, and his extremities are cold. An ECG is shown. Which of the following is the best next step in the management of this patient?
سؤال مجاني 7 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. synchronized cardioversion
The ECG image is not provided, but the answer does not depend on it. The patient has a tachyarrhythmia with a pulse (HR 240) and is haemodynamically unstable: BP 65/40, cold, diaphoretic. The history of episodes stopped by vagal manoeuvres suggests a re-entrant SVT. Any unstable tachyarrhythmia with a pulse is treated with immediate synchronised cardioversion. Adenosine, vagal manoeuvres and antiarrhythmics such as amiodarone are for stable patients. Fluids do not treat the arrhythmia.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Antiarrhythmic infusions such as amiodarone are given for stable wide-QRS tachycardia; this patient is hypotensive, cold and diaphoretic.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 13 -
B
ليش غلط
Fluids are not the algorithm's response: a persistent tachyarrhythmia causing hypotension or signs of shock goes to synchronized cardioversion.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 13 -
C
ليش غلط
Adenosine and vagal manoeuvres are for hemodynamically stable SVT; unstable patients are treated with emergency cardioversion.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 13 -
D
ليش صح
With hypotension and shock signs, a persistent tachyarrhythmia needs emergency synchronized cardioversion; he is unstable and vagal manoeuvres have already failed.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 13
- المصدر
- CARDIOLOGY - ARRHYTHMIA.pdf · p. 13
- المحاضرة
- Tachy- & Bradyarrhythmia Emergencies · Cardiology · Module B
- ظهر في
- MED43 ♀ Quiz B · MED43 ♀ Compre