Ventricular tachycardia: The Daily PANCE Blueprint

Home Ventricular tachycardia: The Daily PANCE Blueprint

Ventricular tachycardia: The Daily PANCE Blueprint

A 78-year-old male with a history of tobacco use is admitted to the hospital with shortness of breath and dizziness. Initial EKG reveals findings consistent with monomorphic ventricular tachycardia at a rate of 130 bpm. Additional vitals reveal a blood pressure of 118/78 mmHg and oxygen saturation of 92% on room air. Abnormal labs include a troponin I of 0.051 and elevated creatinine of 1.6. What is the next best step?

A. IV amiodarone
B. Synchronized cardioversion
C. Emergent coronary angiogram
D. IV esmolol
E. Referral for ICD placement

Answer and topic summary

The answer is A. IV amiodarone

The treatment of ventricular tachycardia differs depending on the patient’s hemodynamic stability. If the patient is unstable (hypotension, altered mental status, unresponsive, etc.), then urgent electrical cardioversion is indicated. If the patient is stable, then antiarrhythmic therapy is recommended. Options for therapy include IV administration of amiodarone, procainamide, or lidocaine. The patient presented should be initiated on IV amiodarone and will eventually need an ischemic evaluation and electrophysiology consultation.

 

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Smarty PANCE Content Blueprint Review:

Covered under ⇒  PANCE Blueprint Cardiology ⇒ Conduction Disorders (PEARLS) ⇒ Ventricular tachycardia

Also covered under the Emergency Medicine end-of-rotation content blueprint