A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities.
What is the most appropriate next step of management of this patient?
A – Start heparin
B – Start metoprolol
C – Order cardiac enzymes
D – Perform electric cardioversion
E – Refer to a cardiologist
This patient has atrial flutter which is common in elderly hospitalized patients. He needs urgent rate control by metoprolol before conducting any further investigations.
The correct answer is B