A patient with atrial fibrillation is hypotensive, confused and has chest pain. What is the indicated treatment?
Answer and explanation
Correct answer: B. Synchronised direct-current cardioversion
- Step 1: Hypotension, altered mental state and ischaemic pain are signs of haemodynamic instability. Step 2. Unstable tachyarrhythmias are treated at once with synchronised electrical cardioversion. Answer: synchronised cardioversion. Why not the others: Oral drugs are too slow; unsynchronised shocks are for pulseless arrhythmias; digoxin does not cardiovert quickly.
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