A 71-year-old woman presents with palpitations and breathlessness. ECG shows atrial fibrillation with a ventricular rate of 150 beats/min. Blood press...

Question

A 71-year-old woman presents with palpitations and breathlessness. ECG shows atrial fibrillation with a ventricular rate of 150 beats/min. Blood pressure is 95/60 mmHg and she has cool peripheries and chest discomfort. What is the most appropriate first-line management?

Accepted Answer

Urgent DC cardioversion under appropriate monitoring

Answer

Start oral bisoprolol and review in 24 hours

Answer

Arrange elective cardiology clinic referral

Answer

Start oral digoxin and observe on the ward

Answer

Begin a heparin infusion and arrange transthoracic echocardiography only

uk-plab-1 MCQ (SBA): Unstable atrial fibrillation

A 71-year-old woman presents with palpitations and breathlessness. ECG shows atrial fibrillation with a ventricular rate of 150 beats/min. Blood pressure is 95/60 mmHg and she has cool peripheries and chest discomfort. What is the most appropriate first-line management?