MSFinals-0329

A 57-year-old woman presents to the Emergency Department with sudden onset of palpitations and shortness of breath. She is speaking in broken sentences and appears distressed, with visible sweating. Her vital signs are as follows: blood pressure 70/30, heart rate 180 bpm, respiratory rate 28, and sats 98% on air. Upon auscultation, there are crepitations at both lung bases. The patient reports experiencing crushing chest pain during the assessment. A 12-lead electrocardiogram (ECG) reveals a regular broad complex tachycardia. What is the most appropriate next step in managing this patient?