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A 35 year old male presents to the ED with palpitations and diaphoresis for one hour. His BP is 110/70 and he is awake and talking. He has no chest pain. You obtain EKG # 1 and you treat him with a ______________ IV medication and his rhythm changes to EKG # 2. He now feels much better.
What is your diagnosis of EKG # 1? Regular tachycardia (?wide complex QRS 0.14)
What IV medication did you give to treat EKG # 1? This is a real case, this patient received adenosine
What does EKG #2 show:
Rate: 75
Rhythm: sinus
Axis: 90
PR: 0.12
QRS: 0.12
ST: normal
EKG #2 diagnosis?
- Sinus r/o Wolff Parkinson White (WPW), note the delta wave
After seeing EKG #2, what IV meds are contraindicated if this patient becomes tachycardic again?
- Beta blockers, calcium channel blockers, digoxin
What IV meds could be used if he does become tachycardic again?
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