A 66-year-old male presents with acute dizziness and a pulse of 36 beats per minute. Blood pressure is 74/46 mmHg. What is the initial drug of choice for this unstable bradycardia?
Answer and explanation
Correct answer: B. Intravenous atropine
- Step 1: The patient presents with symptomatic, hemodynamically unstable sinus bradycardia.
- Step 2: Advanced Cardiovascular Life Support guidelines recommend intravenous atropine as the first-line pharmacologic intervention to competitively antagonize muscarinic acetylcholine receptors and increase heart rate.
Answer
Intravenous atropine.
Why not the others: Adenosine slows atrioventricular nodal conduction and is indicated for regular narrow-complex supraventricular tachycardia, not bradycardia. Amiodarone is an antiarrhythmic used in tachyarrhythmias and would worsen bradycardia. Diltiazem blocks calcium channels, further decreasing nodal conduction and heart rate.
Practise more Cardiovascular and Respiratory Medicine.
Free questions with an explanation for every one, and full timed DHA Dubai mock tests.
More Cardiovascular and Respiratory Medicine questions
- A 64-year-old female presents with orthopnea, paroxysmal nocturnal dyspnea, and bilateral lower extremity pitting edema. Echocardiography re…
- A 42-year-old male with a history of deep vein thrombosis presents with sudden-onset pleuritic chest pain and dyspnea. Vital signs show HR 1…
- A 70-year-old male presents with exertional syncope, angina, and dyspnea. Physical examination reveals a late-peaking harsh crescendo-decres…
- A 60-year-old female with long-standing poorly controlled hypertension presents for routine review. Her ECG reveals regular narrow-complex t…
- A 55-year-old male with a 30 pack-year smoking history presents with chronic productive cough and progressive exertional breathlessness. Pos…
- A 28-year-old male is brought to the emergency department following an acute severe asthma attack. Arterial blood gas (ABG) analysis on room…