A patient with a wide complex tachycardia and hypotension after MI should receive which immediate intervention?

A patient with a wide complex tachycardia and hypotension after MI should receive which immediate intervention?

• A. Immediate defibrillation
• B. Anticipate immediate synchronized cardioversion
• C. Start amiodarone infusion
• D. Wait and monitor

Answer: (B)

When a patient has a wide-complex tachycardia and is hypotensive after a myocardial infarction, the arrhythmia is causing poor perfusion and the situation is life-threatening. The immediate goal is to restore circulation as quickly as possible. If the patient has a pulse, synchronized cardioversion is the correct action because it delivers a timed electrical shock that terminates the tachycardia while preserving a coordinated rhythm, rapidly improving hemodynamics. Defibrillation is reserved for situations where there is no pulse (pulseless VT or ventricular fibrillation); in a patient with a pulse, synchronized cardioversion is preferred to avoid shocks that could destabilize the rhythm further. Antiarrhythmic medication like amiodarone may be used later to reduce recurrence, but it does not provide the same immediate restoration of perfusion. Waiting and monitoring would leave the patient at continued risk of deterioration.

When a patient has a wide-complex tachycardia and is hypotensive after a myocardial infarction, the arrhythmia is causing poor perfusion and the situation is life-threatening. The immediate goal is to restore circulation as quickly as possible. If the patient has a pulse, synchronized cardioversion is the correct action because it delivers a timed electrical shock that terminates the tachycardia while preserving a coordinated rhythm, rapidly improving hemodynamics.

Defibrillation is reserved for situations where there is no pulse (pulseless VT or ventricular fibrillation); in a patient with a pulse, synchronized cardioversion is preferred to avoid shocks that could destabilize the rhythm further. Antiarrhythmic medication like amiodarone may be used later to reduce recurrence, but it does not provide the same immediate restoration of perfusion. Waiting and monitoring would leave the patient at continued risk of deterioration.