USMLE Step 2 - Question 36

A 56 year old male presents to the emergency department with chest pains, nausea and vomiting. His temperature is 37.2, blood pressure 110/70, heart rate 50, respirations 20, and oxygen saturation normal on room air. Physical examination reveals normal breath sounds, an S4 heart sound, and a regularly irregular rhythm. Laboratory studies reveal an elevated troponin I level. His ECG is below. What is the treatment for his heart rhythm?


A. Atropine

B. Adenosine

C. Emergency pacemaker placement

D. Observation