2 Hours Of Palpitations in Medicine / Internal Medicine — 72yo Man | Cardiology | SMLE Q#11624
SMLE Question #11624
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 72-year-old man with chronic HFrEF (LVEF 30%) and long-standing nonvalvular atrial fibrillation presents with 2 hours of palpitations and worsening exertional dyspnea. He has been inconsistently taking his heart failure medications and is not on anticoagulation. Examination shows bibasilar crackles and mild bilateral ankle pitting edema. ECG confirms atrial fibrillation with a ventricular rate around 130/min. Which of the following is the most appropriate medication for rate control in this patient?
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