Question

A patient presents to the emergency department with new onset of dizziness and fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95. What is the most appropriate treatment for this patient?

1) Epinephrine 1 mg every 3 to 5 minutes
2) Atropine 0.5 mg
3) Amiodarone 150 mg
4) Dopamine infusion

Answer 1

The most appropriate treatment for a patient with symptomatic bradycardia and hypotension is an initial dose of Atropine 0.5 mg, as it works to increase the heart rate and improve hemodynamic stability.

Step-by-step explanation:

A patient presenting with new onset of dizziness and fatigue, a heart rate (HR) of 35/min, and low blood pressure (70/50 mm Hg) is exhibiting signs of bradycardia with hemodynamic instability. Considering these symptoms - dizziness, fatigue, and the recorded low HR and blood pressure - the patient is likely in need of urgent intervention to support the cardiovascular system and improve blood flow to vital tissues. Among the treatment options provided:

• Atropine 0.5 mg is the most appropriate initial treatment to increase heart rate in the setting of symptomatic bradycardia.
• Epinephrine would typically be used in cardiac arrest, not isolated bradycardia.
• Amiodarone is used for arrhythmias like atrial fibrillation or ventricular tachycardia and is not indicated here.
• Dopamine infusion could be considered if Atropine is ineffective, but it is not the first-line choice.

Hence, the most appropriate treatment for this patient is Atropine 0.5 mg.