A 65 year old man presents with chest pain and shortness of breath. ECG shows atrial fibrillation with rapid ventricular response at 150 beats per min...

Question

A 65 year old man presents with chest pain and shortness of breath. ECG shows atrial fibrillation with rapid ventricular response at 150 beats per minute. He is hypotensive with systolic blood pressure 80 mm Hg and has signs of pulmonary oedema. What is the most appropriate immediate management?

Accepted Answer

Perform urgent synchronised electrical cardioversion

Answer

Start oral beta blocker and observe

Answer

Start intravenous amiodarone and wait for effect

Answer

Administer digoxin alone intravenously

Answer

No specific treatment is required for rate control

ca-mccqe1 MCQ (SBA): Unstable atrial fibrillation

A 65 year old man presents with chest pain and shortness of breath. ECG shows atrial fibrillation with rapid ventricular response at 150 beats per minute. He is hypotensive with systolic blood pressure 80 mm Hg and has signs of pulmonary oedema. What is the most appropriate immediate management?