Advanced Cardiovascular Life Support (ACLS) Practice Exam

A 62-year-old man reports a fast heart rate without chest pain. What intervention should you perform next?

1. Obtain a 12 lead ECG

2. Administer immediate sedation

3. Initiate cardiac monitoring

4. Provide reassurance

The correct answer is: Obtain a 12 lead ECG

In the scenario of a 62-year-old man experiencing a fast heart rate but not reporting chest pain, obtaining a 12-lead ECG is an essential next step. This intervention allows for the identification of the underlying rhythm and can help determine if the tachycardia is due to a potentially life-threatening arrhythmia, such as atrial fibrillation, atrial flutter, or any other significant cardiac condition. The data obtained from the 12-lead ECG provides crucial information about the heart’s electrical activity and can guide further management decisions. Monitoring the electrical activity and assessing for any signs of ischemia or other abnormalities will provide insight into the patient's current cardiovascular status. This is particularly important as heart rate alone does not give a complete picture of a patient's cardiac health, and the presence or absence of chest pain does not negate the possibility of an underlying serious condition. In comparison, while cardiac monitoring is also a crucial intervention, it generally comes after obtaining the ECG to evaluate the rhythm more specifically. Administering immediate sedation should not be the primary response to a fast heart rate without clear indications such as associated dizziness or agitation. Providing reassurance is important for patient comfort but will not address the potential underlying cardiac issues. Therefore, the most clinically appropriate next step