A 63-year-old man undergoes emergent percutaneous coronary intervention for anterior ST-elevation myocardial infarction. One hour post-procedure, telemetry shows a regular wide-complex rhythm at 75 bpm. Vital signs: BP 128/82 mmHg, HR 75, RR 16, SpO2 98% on room air. Troponin I is elevated at 8.2 ng/mL. He remains asymptomatic with no chest pain or dyspnea. Which of the following is the most likely explanation for this rhythm?
- A)Atrial flutter with 2:1 conduction
- B)Torsades de pointes due to prolonged QT
- C)Accelerated idioventricular rhythm due to reperfusionGABARITO
- D)Complete heart block with junctional escape
- E)Monomorphic ventricular tachycardia requiring immediate amiodarone
Explicação
A regular wide-complex rhythm around 50 to 110 per minute appearing after reperfusion is typical of accelerated idioventricular rhythm. It is generally transient and benign, reflecting enhanced ventricular automaticity after restoration of blood flow. Ver explicação completa e trilha adaptativa →