nonsustained VT - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam

Thread Tools Search this Thread Display Modes
Old 06-08-2012
tyagee's Avatar
USMLE Forums Master
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 584 Times in 354 Posts
Reputation: 594
Default nonsustained VT

A 69-year-old woman with a history of severe asthma is brought to the emergency department by her daughter because of severe lightheadedness. The patient also complains of worsening shortness of breath and progressive fatigue over the last year. For the last three months, the patient is able to walk only 2 to 3 blocks before developing a profound shortness of breath. She recently started using three pillows for sleep during the night. She denies chest pain and diaphoresis. The patient's daughter states that three weeks ago, her mother had a syncopal episode that lasted for two minutes on her way to the supermarket. At that time, she did not seek medical attention. The patient's current medications include lisinopril, digoxin, and furosemide.
In the emergency room, her heart rate is 102/min, blood pressure is 115/70 mm Hg, and respiratory rate is 22/min. Physical examination reveals jugulovenous distension and bibasilar crackles. Heart auscultation demonstrates a diminished S1, a loud P2, and an S3 gallop. There is a 1+ pitting edema of both extremities. EKG shows normal sinus rhythm with several multifocal premature contractions (PVCs) and a four-beat run of ventricular tachycardia (VT) at a rate of 128/min. The echocardiogram reveals an ejection fraction below 25% and no evidence of aortic stenosis. The patient is admitted to the telemetry unit, and recordings show PVCs and 12 runs of nonsustained VT of 4 to 18 beats in duration during the first day.
Which of the following is the most appropriate management at this time?
(A) Increase the dose of digoxin
(B) Start metoprolol
(C) Start amiodarone
(D) Cardiac catheterization
(E) Perform electrophysiologic study

by the way, what is the dx in this patient ? is it just VT or it is PVC only ?
Reply With Quote Quick reply to this message

Old 06-09-2012
USMLE Forums Veteran
Steps History: 1+CK+CS+3
Posts: 246
Threads: 18
Thanked 142 Times in 86 Posts
Reputation: 152

This pt has recurrent PVC/VT mostly likely as a result of severe lung dz
I know that the best rx for this ventricular arrhythmia is ICD
Reply With Quote Quick reply to this message


Quick Reply

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Please enter a password for your user account. Note that passwords are case-sensitive.
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Where you live. Leave blank if you don't want to tell.


Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2016 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)