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A 72 year old female presents with weakness. She reports a history of some sort of a heart problem and takes medication for it, but does not remember the name of it. Rate: ~30 to 40 Rhythm: A. fib with slow ventricular response Axis: Normal PR: no p waves QRS: normal ST: scooping ventricular repolarization, digitalis effect, also possible ischemia EKG Diagnosis: A fib with slow ventricular response What electrolyte is important to know in this setting? K+ Treatment: Check potassium, check digoxin level, possible digibind, r/o ischemia Should the patient be paced? Try to avoid pacing in setting of digoxin toxicity as it may lead to a malignant arrhythmia. |