Diagnosis: Supraventricular tachycardia, stable
Evaluated patient for stability and suspect H and stable given:
No respiratory distress.
No chest pain that is suspected to be ischemic.
Mentating well with no evidence of encephalopathy on exam.
Maintaining sufficient blood pressure.
  • Give instability, will elect for pharmacologic conversion of supraventricular tachycardia. Pads on pt in case of hemodynamic deterioration
    • Adenosine 6 mg IV push with flush afterwards administered.
    • Refractory to initial adenosine
    • Adenosine 12 mg IV flush with flush afterwards administered.
    • Normal heart rate.
    • Repeat EKG obtained.
    • On repeat EKG:
      • EKG: Normal Sinus Rhythm. No arrythmia (no PACs, no PVCs), no brugada wave, no prolonged QTc, no delta wave/no shortened PR, no episilon wave, no evidence of ischemia. Interpretation: No cardiogenic etiology for arrhythmia obvious on EKG.
     Will evaluate for underlying precipitance that may have caused arrhythmia as above.
          CBC to evaluate for significant anemia
          BMP and Magnesium and phosphorus to evaluate for electrolyte abnormalities.
          Chest x-ray
     to evaluate for occult infections that were not elucidated on review of systems or examination.
     Evaluate for myocardial ischemia resulting from episode of arrhythmia.
Will administer rate control to prevent subsequent episode.
Cardiology consulted.

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