Again, this is a topic, for which you can only rely on textbooks and guidelines. It is impossible to find a good recent article on the topic.

Our aim was to discuss the management of heart rate exacerbations during acute stroke. Do you know a good mnemonic for causes of tachyarrhythmia? I don’t, so here is a new one: DA FAT CHAP

  • Delirium
  • Anxiety
  • Fever
  • Alcohol withdrawal
  • Toxic, Thyroid
  • Cardiac: heart failure, endocarditis
  • Hypovolemia
  • Air hunger
  • Anemia
  • Pain

The procedure is:

  • write an ECG
  • test the rhythm if unsure (use carotid massage or Adenosine to brake)
  • draw some labs (Elytes including Mg, CRP, CBC, TSH),
  • check the other causes above (try some Morphine, some O2, some NaCL)
  • possibly substitute Mg and K
After that you can consider the drugs:
  • Metoprolol (use more than expected) or Esmolol (if you are not sure)
  • Digoxin
  • Amiodarone
  • Verapamil
  • Clonidine

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