Question

A 37-year-old woman with a history of Wolff-Parkinson-White presents to the emergency department with shortness of breath and lightheadedness. Her vital signs on arrival are T 36.9°C, HR 160, BP 80/50, RR 27. Her ECG reveals a narrow complex regular tachycardia. Which of the following is the most appropriate next step in the management of this patient?

1) Adenosine
2) Cardioversion
3) Fluid bolus
4) Procainamide

Answer 1

The most appropriate next step in the management of a patient with Wolff-Parkinson-White syndrome presenting with hypotensive tachycardia is cardioversion, which is an urgent treatment to restore normal heart rhythm.Hence, the correct answer is option 2.

Step-by-step explanation:

The subject of this question is regarding the emergency management of a patient with Wolff-Parkinson-White syndrome (WPW) presenting with symptoms of tachycardia. The primary concern in the acute setting, given the patient's unstable vital signs with hypotension and tachycardia, is to stabilize the cardiac rhythm. The most appropriate next step in the management of this patient is cardioversion. Cardioversion is an urgent treatment that delivers a controlled electric shock to the heart to restore a normal heart rhythm. It is indicated here due to the patient's hemodynamic instability (evidenced by a low blood pressure and high heart rate) and the lack of efficacy of other options like adenosine in WPW during certain types of tachyarrhythmias.