CASE SCENARIO: ARRHYTHMIAS (ATRIAL FIBRILLATION)

A case of Ruben Alonzo, 72 year-old, married from Putik. He was apparently well for the past
few days. Five (5) PTA, he suddenly experienced acute onset of palpitations and mild shortness
of breath, low grade fever and body weakness which prompted his admission for further work
up. He has a history of leukemia and active chemotherapy treatment. His respiratory rate is 24
per minute, BP is 100/60 mm Hg, Heart rate is 145 bpm, Temp-37.7℃ and oxygen saturation is
90% on room air. Oxygen inhalation was administered at 2-3 lits/ min via nasal cannula.

DIAGNOSTICS
CBC
12 LEADS ECG - reveals atrial fibrillation with an uncontrolled ventricular response.
CHEST X-RAY PA VIEW
CARDIAC ENZYME- TROPONIN-I

THERAPEUTICS
Carvedilol 6.25 mg. PO, OD, hold for HR <60 and BP< 90/70
Clopidogrel 75 mg PO, OD post lunch
Amniodarone 300 mg IV bolus Stat