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Heparin bolus (4000u), infusion Plan for rate control 25 mg IV diltiazem given HR = 143 25 mg IV repeat dose diltiazem given HR = 143 Diltiazem drip 10 mg/ hr for ~20 min HR remained 140 - 155 Then the patient developed Cardiogenicshock and echo had poor contractility Amiodarone load given. Patient intubated.
Given the consistency of the clinical profile with typical angina, associated risk factors, and abnormal ECG findings, a cardiology consult was promptly requested. It’s judicious, then, to arrange for coronaryangiogram. Severe Tachycardia [HR 75 bpm] Acute Coronary Syndrome (occlusive coronary disease) a.
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