A 54-year-old male presents to the emergency department with complaints of episodic palpitations and lightheadedness. On examination, his heart rate is 150 bpm, consistent with narrow-complex tachycardia on ECG. Vagal maneuvers such as bearing down fail to terminate the rhythm. After ensuring no carotid bruits or contraindications such as recent stroke or carotid artery disease, a carotid sinus massage is performed on the right side while monitoring the ECG. Which of the following mechanisms underlie the effectiveness of carotid sinus massage?
A 70-year-old man presents with recurrent episodes of syncope. His medical history includes hypertension and atrial fibrillation. A carotid sinus massage is performed as part of the diagnostic evaluation. Of the following, which is true concerning carotid sinus massage?
A 62-year-old male is admitted with fever, cough and chest pain and found to have pneumonia. On days 2, he complains of palpitations associated with anxiety. The nurse reports the patient’s blood pressure is 140/80 mm Hg and a heart rate of 160 beats/minute. ECG demonstrated atrioventricular nodal reentry tachycardia. You decided to use some maneuvers before treating him with medications. Of the following, which maneuver is beneficial for atrioventricular nodal reentry tachycardia (AVNRT) reversal to normal sinus rhythm?
A 37-year-old man comes to the emergency room complaining of lightheadedness and palpitations for a few hours. He did some exercise in the gym and drank coffee just before his symptoms started. He drinks up to 5 cups of coffee a day, especially on the days he drives his truck for work. An electrocardiogram demonstrates a supraventricular tachycardia at a rate of 210 beats/minute. To interrupt his arrhythmia, you decided to use a medication that increases outward potassium current from myocytes. Of the following, which is true about this medication?
Which of the following patients with persistent atrial fibrillation is ideal for rhythm control with flecainide?
A 36-year-old man presents to the emergency room complaining of palpitations and restlessness. He has had multiple admissions in the last 6 months to the hospital for atrial fibrillation. His temperature is 96 ⁰ F, heart rate is 162 beats per minute, respiratory rate is 27 breaths per minute, and blood pressure is 85/55 mm Hg. On physical examination, he is cool to touch, diaphoretic, and mildly hypotensive. His electrocardiogram demonstrates an irregular supraventricular tachycardia. Patient is admitted and his heart rate is controlled. Echocardiogram shows a structurally normal heart. You thought of starting this patient on flecainide. Which of the following is true about this medication?
A 77 year-old female comes to her gastroenterologist office for an elective colonoscopy procedure. Her medical history is significant for congestive heart failure and hypertension. After the procedure, she reports shortness of breath and palpitations. An ECG is taken, which reveals atrial fibrillation. Emergent cardioversion failed to relieve her symptoms. An extra dose of metoprolol 25 mg improved her shortness of breath and palpitations. She is breathing comfortably on room air with oxygen saturation by pulse oximetry 97%. Blood pressure is 145/94 mm Hg. Heart rate is 112 beats/min at rest. At the time of discharge, she informs you that she is averse to frequent blood tests and prefers to ‘stay at home’. Which of the following medications is indicated for long-term anticoagulation in this patient?
Of the following, which is the major source of thromboembolism and stroke in patients with atrial fibrillation?
A 74 year-old male is brought to the emergency room with severe headache, confusion, vomiting and loss of balance. His medical history is significant for atrial fibrillation treated with metoprolol and rivaroxaban. Physical examination reveals weakness on the right side of his body. A CT scan of his head reveals severe acute bleeding in the cerebellum. Of the following, which specific agent is approved for the management of this patient?
