Long-standing Hypertension To Emergency in Medicine / Internal Medicine — 67yo Man | Cardiology | SMLE Q#16623
SMLE Question #16623
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 67-year-old man with long-standing hypertension presents to the emergency department with sudden-onset palpitations for 1 hour. He denies chest pain, syncope, and dyspnea. Cardiac auscultation reveals an irregularly irregular rhythm without murmurs. ECG shows atrial fibrillation with rapid ventricular response and no ischemia or pre-excitation. He is alert and hemodynamically stable. What is the most appropriate initial treatment?
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