Question:
A patient with atrial fibrillation and mitral stenosis presents within 4 hours of symptom onset and is hemodynamically stable. What is the next best step?
A patient with atrial fibrillation and mitral stenosis presents within 4 hours of symptom onset and is hemodynamically stable. What is the next best step?
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Recent-onset AF less than 48 hours may be managed with cardioversion if appropriate.
Updated On: May 14, 2026
- Ventricular rate control
- Cardioversion
- Anticoagulation
- Wait and watch
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The Correct Option is B
Solution and Explanation
Concept:
In recent-onset atrial fibrillation within 48 hours, rhythm control with cardioversion may be considered, especially when onset is clearly known.
Step 1: Identify rhythm problem.
The patient has: \[ \text{Atrial fibrillation} \]
Step 2: Check duration.
Symptoms started within: \[ 4\ \text{hours} \] which is less than 48 hours.
Step 3: Choose next step.
Therefore, cardioversion is the next best step.
Step 1: Identify rhythm problem.
The patient has: \[ \text{Atrial fibrillation} \]
Step 2: Check duration.
Symptoms started within: \[ 4\ \text{hours} \] which is less than 48 hours.
Step 3: Choose next step.
Therefore, cardioversion is the next best step.
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