A 66-year-old man with prior anterior wall myocardial infarction presents with acute palpitations and near syncope. Vital signs: BP 78/48 mmHg, HR 180 bpm, RR 22, SpO2 92% on room air. Telemetry reveals a regular wide-complex tachycardia. Troponin and electrolytes are normal. Chest X-ray shows no acute pulmonary process. He denies chest pain. He takes metoprolol and lisinopril. Which of the following is the most appropriate immediate management?
- A)Observation only
- B)Synchronized cardioversionGABARITO
- C)Carotid sinus massage
- D)Intravenous atropine
- E)Adenosine administration
Explicação
Synchronized cardioversion is correct. Hemodynamically unstable ventricular tachycardia requires immediate synchronized cardioversion. Scar related reentry after prior myocardial infarction is a classic substrate for monomorphic ventricular tachycardia with a ... Ver explicação completa e trilha adaptativa →