A 40 year old man was admitted to the hospital emergency with sudden onset of symptoms and signs of severe left ventricular failure. What would be the best management of this patient?
Correct Answer: DC Shock 25-50J
Description: ECG shows atrial flutter with 2:1 block. Since the patient is in acute LVF, Beta blockers are contraindicated. Since the circulation of patient is compromised, Cardioversion ( DC shock 25-50 J) is indicated. Ibutilide is used for rhythm control but at the moment prompt treatment is warranted. Digoxin is not an answer because: -It is a pro-arrythmogenic drug -Takes time to achieve therapeutic levels
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