u/boxoverengine

86 year old male called for difficulty breathing. Respiratory rate was >40, wet lung sounds audible without auscultation, hypertensive. No hx of heart failure, no peripheral edema noted. Initially rate was variable between 150-170. Pads were applied, CPAP and nitro administered. Rate climbed to 200, pressure remained high. The patient became obtunded and they were synchronized cardioverted.

The rhythm was >.12ms and had a short PRI. My rhythm DDx were atrial flutter with LBBB, vtach, and some sort of WPW. Figured the patient was experiencing cardiogenic pulmonary edema. Im just a newer medic looking for a little help.