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Muna1:
A 52-year-old female is referred from the Emergency Department with a pulse of 36 beats/min. The ECG shows complete heart block with a narrow QRS complex. Blood pressure is 110/70 and there is no evidence of heart failure. What is the most appropriate management?

Doctoor:
Complete heart block + bradycardia + narrow QRS complex without heart failure treated by dual chamber permenant pacemaker.
Doctoor

Muna1:
your answer is  correct.
the patient is stable Bp 110/70 ,no sign of heart faliure but her pulse is 36 /min require intervention so the first step is to give atropine iv .If this fails to work, or there is the potential risk of asystole then transvenous pacing is indicated and  adrenaline infusion titrated to response .and patient need dual chamber permanent pacemaker.
thank you

Admin:
Congratulations,
The 15 points of this case goes to Doctoor
Regards
Dr.Mahdi

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