Question

A 74-year-old man with atrial fibrillation becomes acutely hypotensive, with chest pain and signs of pulmonary oedema. His heart rate is 180/min and irregular. What is the most appropriate immediate management?

Accepted Answer

Attempt immediate synchronised DC cardioversion

Answer

Start oral beta-blocker and review in 24 hours

Answer

Start rate-control with Digoxin alone

Answer

Give IV Amiodarone over 24 hours

Answer

Observe only; AF is usually benign

Practice question

A 74-year-old man with atrial fibrillation becomes acutely hypotensive, with chest pain and signs of pulmonary oedema. His heart rate is 180/min and irregular. What is the most appropriate immediate management?