USMLE Step 3 - Question 28

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 and appropriate therapy for acute coronary syndrome is begun. His ECG is below. What is the treatment for his heart rhythm?

2ndDegreeAVB-TypeI

A. Atropine

B. Adenosine

C. Emergency pacemaker placement

D. Observation

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