Elderly Woman With Severe Dyspnea

A 74-year-old woman with a history of mitral valve replacement was admitted to the emergency department (ED) with severe dyspnea accompanied by diaphoresis. On arrival to the hospital, her blood pressure was 96/60 mm Hg, heart rate was rapid and irregular, at 179 beats/min, and blood oxygen saturation was 90% while she breathed 5 L of oxygen by face mask. The patient's lung examination result was remarkable for the presence of bilateral crackles. The ECG on admission is shown in Figure 1. The patient was administered morphine, furosemide, and cedilanid intravenously and showed no significant improvement after the treatment.

https://ift.tt/2AfRN41