A 16-Year-Old Boy Was Brought to the Emergency Department Because

A 16-year-old boy was brought to the emergency department because of palpitations and lightheadedness that began 16 hours ago. He had been binge drinking the night before. After regaining consciousness, he was admitted for observation. His temperature is 37.1°C (98.8°F) , pulse is 220/min, respirations are 20/min, and blood pressure is 92/54 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 98%. Physical examination shows no abnormalities.   An ECG shows a regular heart rate of 240/min with narrow QRS complexes and no identifiable P waves. . Which of the following is the most likely cause of this patient's hypotension?

A) Decreased effective intravascular volume
B) Decreased myocardial contractility
C) Decreased peripheral vascular resistance
D) Left-to-right intracardiac shunting
E) Shortening of ventricular diastole

Correct Answer:

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