A 72-year-old woman is found to have irregularly irregular pulse at a wellness visit. ECG shows atrial fibrillation at 86/min. She has hypertension

Question

A 72-year-old woman is found to have irregularly irregular pulse at a wellness visit. ECG shows atrial fibrillation at 86/min. She has hypertension and diabetes. She has no chest pain, syncope, heart failure symptoms, or contraindication to anticoagulation. Which of the following is the most appropriate next step in management?

Accepted Answer

Start oral anticoagulation for stroke prevention

Answer

Schedule elective cardioversion without anticoagulation planning

Answer

Observe without stroke prevention

Answer

Start aspirin as equivalent therapy

Answer

Admit for emergent synchronized cardioversion

New atrial fibrillation — USMLE Step 3 MCQ