🏥 USMLE Exam Prep

A 48-year-old male presents to the emergency department with sudden onset palpitations, lightheadedness, and shortness of breath. ECG shows atrial fibrillation with a rapid ventricular rate of 160 bpm. He is hemodynamically stable with a blood pressure of 120/80 mmHg and no signs of acute heart failure. What is the most appropriate initial management for this patient?

A Synchronized cardioversion
B Intravenous diltiazem
C Intravenous amiodarone
D Oral warfarin initiation

✓ Correct Answer: Option B

For hemodynamically stable patients with atrial fibrillation and rapid ventricular response, rate control is the initial goal. Intravenous beta-blockers (e.g., metoprolol) or calcium channel blockers (e.g., diltiazem, verapamil) are preferred.

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