]> 2026-07-31T07:52:04+00:00 WBR0454 0 en Repeat electrocardiogram '''Incorrect''' No need to repeat the electrocardiogram Echocardiogram '''Incorrect''' Echocardiogram is a must for all heart failure patients to know whether it is systolic or diastolic dysfunction and measure ejection fraction. Digoxin '''Incorrect''' Digoxin is not useful in the acute setting Rapid synchronized cardioversion When arrhythmia is the cause of heart failure, the best next step in management is rapid synchronized cardioversion Dobutamine '''Incorrect''' Dobutamine is used when the patient does not respond to preload reduction, it is not the best immediate step here When arrhythmia is the cause of heart failure, the best next step in management is rapid synchronized cardioversion. Successful cardioversion causes the atrium and ventricles to contract coordinated in normal rhythm such that cardiac output can be maintained. ''' Educational Objective:''' Rapid synchronized cardioversion is the management of choice when arrhythmias like atrial fibrillation or ventricular tachycardia are the cause of pulmonary edema. To maintain cardiac output, heart chambers should be in regular rhythm. '''References:''' References:: Page 82,83,84,85 Master the boards Step 2 CK second edition, page 55 Master the boards Step 3 2009 edition<br/> '''Educational Objective:''' <br/> '''References:''' Internal medicine Neeraja Danda M.B.B.S D Cardiovascular 2020-10-28T00:37:33Z 2459150.5260764 WBR0454