Marked Sinus Bradycardia in Medicine / Internal Medicine — 60yo Man | Cardiology | SMLE Q#1035
SMLE Question #1035
Medicine / Internal Medicine
Cardiology
Last updated: February 2026
A 60-year-old man is in the coronary care unit for an acute inferior-wall ST-elevation myocardial infarction confirmed on ECG. Two hours later, he develops worsening lightheadedness and diaphoresis but remains awake. Examination shows elevated jugular venous pressure, no pulmonary crackles, and no new cardiac murmurs. Repeat ECG shows persistent inferior ST-segment elevation with marked sinus bradycardia. What is the most appropriate immediate management to address his hemodynamic instability?
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