drdg
Forum Senior
Topics: 31
Posts: 176
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A 64-year-old male with a history of rheumatic fever presents to you with general malaise and funny heart rhythm for the past 2 weeks. He had an ECHO done last year, which revealed that he had mild degree of mitral stenosis. He was management medically with diuretics. The blood pressure is 150/85 mmhg. EKG shows atrial fibrillation. The next step in his management is:
A. Cardioversion at 5joules
B. Lidocaine
C. Flecainidine
D. Carotid massage
E. Diltiazem
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| Ivonne
Forum Guru
Topics: 51
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Afib for 2 weeks: rate control and anticoagulation therefore I will go with (E) calcium channel blocker
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| hanialkhadher
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| dr in trouble
Forum Guru
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E
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| mjl1717
Forum Hero
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If it was PSVT I would have said carotid massage.. I was torn between carotid massage and calcium channel blocker..
Also I understand even if the patient was unstable cardioversion is the last resort contrary to what Kaplan says..
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| drgeorgie
Forum Senior
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not 2 weeks if AFIB >2 days.....u give ccb+warfarin
if AFIB with decreased cardiac fn then digoxine
correct me if i'm wrong
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| neuroblastoma
Forum Guru
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correct dr georgie
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| drdg
Forum Senior
Topics: 31
Posts: 176
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Yes. the correct answer is E
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