peraspera
Forum Elite
Topics: 38
Posts: 233
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A 67-year-old man who has experienced recurrent
episodes of dizziness over the last several months is admitted
to the hospital because of a fainting episode. No evidence of acute myocardial infarction is documented.
On the evening of admission, the patient tells his nurse
that approximately 10 min earlier he experienced several
minutes of dizziness. His current rhythm appears to be
normal sinus; however, a monitoring strip obtained at the
time of this episode reveals absent QRS complexes every
third beat. The PR interval, while slightly prolonged, is
constant from beat to beat. P waves are present at regular
intervals. Which of the following is the most appropriate
therapeutic action?
(A) Insertion of permanent cardiac pacemaker
(B) Insertion of temporary cardiac pacemaker followed by insertion
of permanent cardiac pacemaker
(C) Administration of atropine, 2 mg IV
(D) Administration of isoproterenol, 2 mg/min IV
(E) No specific therapy is required for this benign arrhythmia
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| starcraftbw
Forum Senior
Topics: 13
Posts: 166
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B
if his bp is low i would do atropine first (wenkebach)
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| Kamsi
Forum Guru
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A
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| doyoudig
Forum Guru
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B...
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| Ivonne
Find a way or make one
Topics: 58
Posts: 1,658
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Well this is MOBITZ II
TX is ventricular pacemaker. I will go with B
Urgent cardiology consult is indicated for patients who have symptomatic type II block and for those asymptomatic patients who are unable to achieve capture with transcutaneous pacing.
Some institutions recommend insertion of a transvenous pacemaker for all new Mobitz type II blocks, although this practice varies greatly from institution to institution.
Is transcutaneous pacemaker equivalent to temporary pacemaker and transvenous to permanent pacemaker?
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| peraspera
Forum Elite
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| arlete
Forum Fanatic
Topics: 50
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A
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| elitoki
Forum Guru
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A
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