A 27-year-old pregnant woman at 24 weeks gestation presents with sudden palpitations and diaphoresis. Vital signs show BP 118/76 mmHg, HR 185/min, RR 20/min, SpO2 98% on room air. ECG demonstrates a regular narrow-complex tachycardia at 185 bpm with no evidence of delta waves. Troponin is normal. She denies chest pain and lung auscultation is clear bilaterally. She takes only prenatal vitamins. Which of the following is the best initial step after obtaining the ECG?
- A)Intravenous procainamide before any bedside maneuvers
- B)Vagal maneuversGABARITO
- C)Immediate unsynchronized defibrillation
- D)Permanent pacemaker placement
- E)No treatment because pregnancy protects against recurrence
Explicação
In a stable patient with suspected AVNRT or AVRT, vagal maneuvers are the best initial intervention, including during pregnancy. These maneuvers can terminate AV node-dependent tachycardia without medication exposure. Ver explicação completa e trilha adaptativa →