A 75-year-old African-American male with no previous history of cardiac problems complains of shortness of breath and a feeling of general weakness. His symptoms have developed over the past 24 hours. On physical examination you find a regular pulse with a rate of 160 beats/min. You note rales to the base of the scapula bilaterally, moderate jugular venous distention, and hepatojugular reflux. His blood pressure is 90/55 mm Hg; when he sits up he becomes weak and diaphoretic and complains of precordial pressure. An EKG reveals atrial flutter with 2:1 block. Management at this time should include A) intravenous digoxin B) intravenous verapamil (Calan, Isoptin) C) amiodarone (Cordarone) D) electrical cardioversion E) insertion of a pacemaker
Posted on: Tue, 22 Apr 2014 14:53:01 +0000
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