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An 8 year-old girl develops bradycardia with poor perfusion on POD #2 after an orthotopic heart transplant. The immediate best treatment is with:
a) Transcutaneous pacing
b) Phenylephrine
c) Endotracheal intubation and positive pressure ventilation with 100% oxygen
d) Epinephrine
e) Atropine
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Answer
Answer d.
The acutely transplanted heart is denervated and will not respond to atropine. Epinephrine is the appropriate pharmacologic agent. If unsuccessful, transcutaneous pacing should be considered.
Notes
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